Patient Education - Lung Cancer Program at UCLA
yourself about lung cancer:
A pleural effusion is an accumulation of fluid between the layers of the membrane
that lines the lungs and chest cavity.
Fluid in the chest; Pleural fluid
Your body produces pleural fluid in small amounts to lubricate the surfaces of
the pleura, the thin membrane that lines the chest cavity and surrounds the lungs.
A pleural effusion is an abnormal collection of this fluid.
Two different types of effusions can develop:
- Transudative pleural effusions are often caused by abnormal lung pressure. Congestive
heart failure is the most common cause.
- Exudative effusions form as a result of inflammation (irritation and swelling)
of the pleura. This is often caused by lung disease. Examples include lung cancer,
pneumonia, tuberculosis and other lung infections, drug reactions, asbestosis, and
- Shortness of breath
- Chest pain, usually a sharp pain that is worse with cough or deep breaths
- Rapid breathing
There may be no symptoms.
Exams and Tests
During a physical examination, the doctor will listen to the sound of your breathing
with a stethoscope and may tap on your chest to listen for dullness.
The following tests may help to confirm a diagnosis:
- Chest x-ray
- Thoracic CT
- Ultrasound of the chest
- Pleural fluid analysis
The cause and type of pleural effusion is usually determined by thoracentesis
(a sample of fluid is removed with a needle inserted between the ribs).
Treatment may be directed at removing the fluid, preventing its re-accumulation,
or addressing the underlying cause of the fluid buildup.
Therapeutic thoracentesis may be done if the fluid collection is large and causing
pressure, shortness of breath, or other breathing problems, such as low oxygen levels.
Treatment of the underlying cause of the effusion then becomes the goal.
For example, pleural effusions caused by congestive heart failure are treated
with diuretics and other medications that treat heart failure. Pleural effusions
caused by infection are treated with antibiotics specific to the causative organism.
In patients with cancer or infections, the effusion is often treated by using a chest
tube to drain the fluid. Chemotherapy, radiation therapy, or instilling medication
within the chest that prevents re-accumulation of fluid after drainage may be used
in some cases.
The expected outcome depends upon the underlying disease.
- A lung surrounded by a fluid collection for a long time may collapse.
- Pleural fluid that becomes infected may turn into an abscess, called an empyema,
which requires prolonged drainage with a chest tube placed into the fluid collection.
- Pneumothorax (air within the chest cavity) can be a complication of the thoracentesis
- In rare cases, surgery is needed to remove the abscess.
When to Contact a Medical Professional
Call your health care provider if symptoms suggestive of pleural effusion develop.
Call your provider or go to the emergency room if shortness of breath or difficulty
breathing occurs immediately after thoracentesis.
Review Date: 8/7/2006
Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary,
Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY.
Review provided by VeriMed Healthcare Network.
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