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Malignant pleural effusion is a condition in which cancer causes an abnormal amount of fluid to collect between the thin layers of tissue lining the outside of the lung and the wall of the chest cavity. [1] Lung cancer and breast cancer account for about 50-65% of malignant pleural effusions.
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional ...
On radiological studies, a pleural pseudotumor is visualized as a biconcave or lenticular lesion using conventional chest x-rays and CT scans. The lesion is most commonly located in the minor (horizontal) fissure of the lung. A pleural pseudotumor is also associated with the presence of dependent pleural effusions. [9]
Asbestos-related diseases are disorders of the lung and pleura caused by the inhalation of asbestos fibres. Asbestos-related diseases include non-malignant disorders such as asbestosis (pulmonary fibrosis due to asbestos), diffuse pleural thickening, pleural plaques, pleural effusion, rounded atelectasis and malignancies such as lung cancer and malignant mesothelioma.
[4] [5] Variability in categorising small-cell lung cancer as limited or extensive occurs with reference to the extent of pleural effusion and nodal stations involvement. [4] [8] In addition, patients with an ipsilateral pleural effusion are frequently excluded from the limited-disease category.
The mesothelioma is indicated by yellow arrows, the central pleural effusion (fluid collection) is marked with a yellow star. Red numbers: (1) right lung, (2) spine, (3) left lung, (4) ribs, (5) descending part of the aorta, (6) spleen, (7) left kidney, (8) right kidney, (9) liver. Micrograph of a pleural fluid cytopathology specimen showing ...
Pleural tumors may be benign (i.e. solitary fibrous tumor) or malignant in nature. Pleural mesothelioma is a type of malignant cancer associated with asbestos exposure. Under most other circumstances, pleural cancers are secondary malignancies associated with lung cancer due to its nearby location or as metastasis such as with breast cancer.
Cytology is an important tool in identifying effusions due to malignancy. The most common causes for pleural fluid are lung cancer, metastasis from elsewhere and pleural mesothelioma. The latter often presents with an effusion. Normal cytology results do not reliably rule out malignancy, but make the diagnosis more unlikely.
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