Clinical Case Database / Category: Patient Management

The management of malignant pleural effusions

Publication details

Charlie Wilkinson MBChB, MRCP(Lon), M
Foundation Years Journal, volume 3, issue 9, p.38 (123Doc Education, London, November 2010)


This article examines the assessment and management strategy of patients with a malignant pleural effusion with the aid of an illustrative case history.

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Charlie Wilkinson MBChB, MRCP(Lon), M

Consultant Physician Calderdale Royal Hospital
Department of General Medicine
Calderdale and Huddersfield NHS Foundation Trust
Salterhebble, Halifax, HX3 0PA


1 Judson MA and Sahn SA. Pulmonary physiologic abnormalities caused by pleural disease. Semi Respir Crit Care Med, 1995, 16:346–353.
2 Antunes G, Neville E, Duffy J, Ali N. BTS guidelines for the management of malignant pleural effusions. Thorax, 2003, 58(Suppl II):ii29–ii38.
3 Blackmore CC, Black WC, Dallas RV, et al. Pleural fluid volume estimation, a chest radiograph prediction rule. Acad Radiol, 1996, 3:103–109.
4 Feller-Kopman. Ultrasound-guided thoracocentesis. Chest, 2006, 129:1709–1714.
5 Medford A and Maskell N. Pleural effusion. Postgrad Med J, 2005, 81:702–710.
6 Maskell NA and Butland RJA. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax, 2003, 58(Suppl II):ii8–ii17.
7 Light RW. Pleural effusion. N Engl J Med, 2002, 346:1971–1977.
8 Davies CWH, Gleeson FV, Davies RJO. BTS guidelines for the management of pleural infection. Thorax, 2003, 58(Suppl II):ii18–ii28.
9 Light RW, Macgregor MI, Luchsinger PC, et al. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med, 1972, 77:507–513.
10 Heffner JE and Klein JS. Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clin Proc, 2008, 83:235–250.
11 Leung AM, Muller NL, Miller RR. CT in differential diagnosis of diffuse pleural disease. ATR, 1990, 154:3–92.
12 Chakrabati B, Ryland I, Sheard J, et al. The role of Abrams percutaneous pleural biopsy in the investigation of exudative pleural effusions. Chest, 2006, 129:1549–1555.
13 Jaklitsch MT, DeCamp MM, Liptay MJ, et al. Video-assisted thoracic surgery in the elderly. A review of 307 cases. Chest, 1996, 110:751–758.
14 Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 1982, 5:649–655.
15 National Patient Safety Agency Rapid Response Report. Risks of chest drain insertion. May 2008 ( (accessed 16/06/2008)


Conflict Of Interest

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Patient Consent statement

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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