Pleural Disease: Malignant and Benign Pleural Effusions

AbstractThere are several pleural diseases that occur either predominantly or exclusively in females. Most of these entities are related to obstetric or gynecological conditions. In this article, we will provide an overview of Meigs' syndrome, ovarian hyperstimulation syndrome, endometriosis, catamenial pneumothorax, catamenial hemothorax, pleural effusions that occur in the peripartum period, lymphangioleiomyomatosis, and malignant pleural effusions related to breast cancer. As most of these diagnoses are rare, considerable expertise is required to identify, diagnose, and manage these patients. The aim of this article is to present an overview of the most common forms of pleural disease affecting women, and to provide an easy reference source on current best practice.

Download Full-text

Managing Pleural Disease in Acute Medicine (I): Pleural Effusion

Acute Medicine Journal ◽

10.52964/amja.0176 ◽

2007 ◽

Vol 6 (3) ◽

pp. 114-120

Author(s):

Nazir I. Lone ◽

◽

George Antunes ◽

Keyword(s):

Clinical Practice ◽

Pleural Effusion ◽

Pleural Space ◽

Diagnostic Approach ◽

Initial Assessment ◽

Common Finding ◽

Pleural Disease ◽

Pleural Effusions ◽

Acute Medicine ◽

Recent Developments

A pleural effusion is the accumulation of fluid in the pleural space. It is a relatively common finding in clinical practice. The diagnostic approach to the patient presenting with a pleural effusion is aimed at defining the effusion as a transudate or an exudate. This review summarises the initial assessment and investigation of pleural effusions diagnosed during the acute medical take, and who should be referred for specialist advice. In addition, recent developments, including the measurement of NT-proBNP levels and diagnostic markers for mesothelioma, are presented.

Download Full-text

Minithoracoscopy for Pleural Effusions

Canadian Respiratory Journal ◽

10.1155/1998/502160 ◽

1998 ◽

Vol 5 (4) ◽

pp. 253-254 ◽

Cited By ~ 5

Author(s):

RA Malthaner ◽

RI Inculet

Keyword(s):

Therapeutic Approach ◽

Pleural Space ◽

Rapid Recovery ◽

Pleural Disease ◽

Direct Visualization ◽

Pleural Effusions ◽

Current Management

The current management of pleural disease often requires direct visualization and biopsy of the pleural space using thoracoscopy. A diagnostic and therapeutic approach to pleural disease is described that uses a new 2 mm rigid thorascope. The technique allows complete visualization, biopsy and drainage of the pleural space with rapid recovery and minimal pain.

Download Full-text

Pleural assessment

Focused Intensive Care Ultrasound ◽

10.1093/med/9780198749080.003.0015 ◽

2019 ◽

pp. 133-140

Author(s):

Jennie Stephens

Keyword(s):

Intensive Care ◽

Care Setting ◽

Pleural Disease ◽

Pleural Effusions ◽

Intensive Care Setting

This chapter describes the use of ultrasound to assess pleural disease in the intensive care setting. The ultrasound signs of pneumothorax are described and the specificity reviewed, with the pitfalls highlighted. The assessment and quantification of pleural effusions are outlined, together with the limitations and pitfalls.

Download Full-text

Pleural Disease: Malignant and Benign Pleural Effusions

Oncologic Critical Care ◽

10.1007/978-3-319-74698-2_62-1 ◽

2018 ◽

pp. 1-9

Author(s):

María F. Landaeta ◽

Macarena R. Vial

Keyword(s):

Pleural Disease ◽

Pleural Effusions

Download Full-text

Diagnosis dan tatalaksana terbaru penyakit pleura

Wellness And Healthy Magazine ◽

10.30604/well.58212020 ◽

2020 ◽

Vol 2 (1) ◽

pp. 69-78

Author(s):

Ni Putu Nita Pranita

Keyword(s):

Pleural Effusion ◽

Pleural Fluid ◽

Malignant Pleural Effusion ◽

Bronchopleural Fistula ◽

Disease Process ◽

Standard Of Care ◽

Underlying Disease ◽

Pleural Disease ◽

Pleural Effusions

Pleural effusion is a common problem. Pleural effusion developed as a sequel to the underlying disease process, including pressure/volume imbalance, infection, and malignancy. In addition to pleural effusion, persistent air leak after surgery and bronchopleural fistula remain a challenge by a physician. An understanding of the pleural disease, including its diagnosis and management, has made an extraordinary step. The introduction of molecular detection of organism-specific infections, risk stratification, and improvement in the non-surgical treatment of patients with pleural infection are all within reach and maybe the standard of care shortly. This article discusses the role of existing techniques, and some of the more recent ones, which are now available for establishing the diagnosis of pleural disease. The initial approach to diagnosis usually begins by distinguishing between transudates and exudates, based on the concentration of protein and lactate dehydrogenase (LDH) in pleural fluid. The exact role of amylase and LDH can provide additional information towards the differential diagnosis of various exudative pleural effusions. With newer cytochemical staining techniques in pleural fluid, diagnostic results of malignant pleural effusion can increase by up to 80%. Ultrasound (US) and thoracic computed tomographic (CT) scans have further improved the diagnosis of undiagnosed pleural effusion. The reappearance of thoracoscopy as the latest diagnostic and therapeutic tool (e.g., Pleurodesis) for undiagnosed or recurrent pleural effusions. Management of malignant pleural effusion continues to develop with the introduction of tunneled pleural catheters and chemical pleurodesis procedures. Advances in the diagnostic and therapeutic evaluation of pleural disease and what appears to be an increasing multidisciplinary interest in a doctor managing patients with pleural disease.

Download Full-text

Indwelling pleural catheters: an overview and real-life experience

QJM ◽

10.1093/qjmed/hcz116 ◽

2019 ◽

Vol 112 (8) ◽

pp. 599-604 ◽

Cited By ~ 2

Author(s):

S J Messeder ◽

M C Thomson ◽

M K Hu ◽

M Chetty ◽

G P Currie

Keyword(s):

Longitudinal Studies ◽

Life Experience ◽

Real Life ◽

Pleural Disease ◽

Safe Procedure ◽

Malignant Diseases ◽

Pleural Effusions ◽

Common Site ◽

Tertiary Centre ◽

Trapped Lung

Abstract Background Indwelling pleural catheters (IPCs) are most frequently used in those with malignant pleural effusions, although their use is expanding to patients with non-malignant diseases. Aim To provide an overview of IPCs and highlight how, when and why they can be used including our own real-life experience. Design Data were collected retrospectively from a large tertiary centre for all individuals who received an IPC between June 2010 and February 2018 inclusive. The data collected included gender, age, origin of malignancy, number of drains prior to IPC, whether they had received pleurodesis prior to IPC, presence of a trapped lung, date of insertion, documented complications, overall outcome and date of death. Results A total of 68 patients received an IPC, the majority were female (n = 38, 57%) with an overall median age of 68 years (range 40–90 years). The most common site of cancer origin was lung (n = 33, 49%) followed by pleura (n = 10, 15%) and breast (n = 9, 13%). The median survival of all patients was 141 days (IQR 26–181). Sixteen percent (n = 11) of patients underwent a spontaneous pleurodesis resulting in their IPC being removed. Only three individuals had a complication (4.4%). Conclusions IPC insertion is a safe procedure and represents an exciting and expanding field in the management of pleural disease. Further longitudinal studies are required to fully delineate their place in the management of both malignant and benign effusions.

Download Full-text