A pleural effusion is a condition where extra fluid builds up in the pleural space, the space between the edge of the lungs and the chest wall. A malignant pleural effusion is caused by cancer that grows in the pleural space. About half of people with cancer develop a pleural effusion. More than 75% of people with a malignant pleural effusion have lymphoma or cancers of the breast, lung, or ovary.

Symptoms

People with a pleural effusion may experience the following symptoms:

• Shortness of Breath
  
  
• Dry cough
  
  
• Pain
  
  
• Feeling of chest heaviness
  
  
• Inability to exercise
  
  
• Malaise (feeling unwell)

Diagnosis

The following tests may help diagnose a malignant pleural effusion, find the exact location of the pleural effusion, or plan treatment:

• A physical examination
  
  
• A chest x-ray (a picture of the inside of the body), which shows the buildup of fluid
  
  
• Computed tomography (CT or CAT) scan (an imaging test that creates a three-dimensional picture of the inside of the body with an x-ray machine) Learn more about what to expect when undergoing a CT scan.
  
  
• Ultrasound (an imaging test that uses sound waves to create a picture of the inside of the body)
  
  
• Thoracentesis (the removal and analysis of fluid from the pleural cavity with a needle)

Treatment

A pleural effusion may require treatment in a hospital. The most common treatment is to drain the malignant pleural fluid. This may be done in several ways:

• Thoracentesis (see above)
  
  
• Tube thoracostomy (insertion of a tube in the chest) for about 24 hours followed by pleurodesis (a process in which substances, such as talc, are used to try to get the edge of the lung to stick to the chest wall to decrease the chance of the fluid returning)
  
  
• The insertion of a port, catheter (a small tube placed into a vein temporarily), or shunt (a device used to bypass or divert fluid from one place to another) to drain excess fluid. Learn more about ports and catheters (this is a new feature scheduled for 10/19)

Although a malignant pleural effusion is treatable, it is a serious, potentially life-threatening condition. Most patients with this condition are eligible for hospice services; talk with your health care team for more information.

More Information

Managing Side Effects

Last Updated: September 25, 2009