Management of malignant pleural effusions

作者：Veena B. Antony, Robert Loddenkemper, Philippe Astoul, Christian Boutin, Peter Goldstraw, Jeffrey Hott, Francisco Rodríguez Panadero, Steven A. Sahn · 发表于：European Respiratory Journal · 年份：2001 · DOI：10.1183/09031936.01.00225601 · 被引用次数：529 · 研究领域：Pleural and Pulmonary Diseases、Occupational and environmental lung diseases、Pneumothorax, Barotrauma, Emphysema

⇓Malignant pleural effusions are a common clinical problem in patients with neoplastic disease. In one post mortem series, malignant effusions were found in 15% of patients who died with malignancies 1. Although there have been no epidemiological studies, the annual incidence of malignant pleural effusions in the United States is estimated to be >150,000 cases (table 1⇓) 2–17. Malignant pleural effusion is also one of the leading causes of exudative effusion; studies have demonstrated that 42–77% of exudative effusions are secondary to malignancy 18, 19. Fig. 1.— Malignant pleural effusions: sensitivity (%) of different biopsy methods (cytological and histological results combined). Presented is a prospective simultaneous comparison (n=208). Fig. 2.— Diagnostic sensitivity of cytology (□) and medical thoracoscopy (![Graphic][1] ) in malignant pleural effusions. n-numbers are as follows: lung cancer, 67; non-lung primary, 154; mesothelioma, 66; total, 287. Fig. 3.— View this table: Table 1— Incidence of malignant pleural effusions (MPEs) Nearly all neoplasms have been reported to involve the pleura. In most studies, however, lung carcinoma has been the most common neoplasm, accounting for approximately one-third of all malignant effusions. Breast carcinoma is the second most common. Lymphomas, including both Hodgkin's disease and non-Hodgkin's lymphoma, are also an important cause of malignant pleural effusions. Tumours less commonly associated with malignant pleural effusions...