TY - CHAP M1 - Book, Section TI - Malignant Pleural Effusions A1 - Sahn, Steven A. A1 - Huggins, John T. A2 - Grippi, Michael A. A2 - Elias, Jack A. A2 - Fishman, Jay A. A2 - Kotloff, Robert M. A2 - Pack, Allan I. A2 - Senior, Robert M. A2 - Siegel, Mark D. Y1 - 2015 N1 - T2 - Fishman's Pulmonary Diseases and Disorders, 5e AB - A malignant pleural effusion is diagnosed by detecting exfoliated malignant cells in pleural fluid or demonstrating these cells in pleural tissue obtained by percutaneous pleural biopsy, thoracoscopy, thoracotomy, or at autopsy. In a number of patients, even though the pleural effusion is caused by the malignancy, neoplastic cells cannot be detected in pleural fluid or pleural tissue and, in fact, probably are not present in these tissues. It is logical to categorize these pleural effusions associated with malignancy, in which there is no direct pleural involvement with tumor and no other cause for the effusion is found, as paramalignant effusions (Table 77-1). Lymphatic obstruction appears to be the most common mechanism for the development of a paramalignant effusion. Other local effects of the tumor causing a paramalignant effusion are bronchial obstruction resulting in pneumonia or atelectasis. Furthermore, it is important for the clinician to recognize that effusions can result from systemic effects of the tumor and adverse effects of therapy. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1122363242 ER -