Abstract
Malignant pleural effusion (MPE) is a common and challenging problem. Patients affected
by MPE have a poor prognosis and suffer from breathlessness and impaired quality of
life. The management of MPE has barely changed for many decades; however, recent research
has driven new paradigms in the diagnosis and treatment of MPE and stimulated novel
concepts that are being evaluated in many ongoing studies. This review provides an
overview of recent advances in the diagnosis of MPE, including new cytopathology and
imaging techniques, and the landmark studies that provide a solid evidence base to
support the use of indwelling pleural catheters as first-line treatment in MPE. Lingering
management dilemmas, including optimal chest drainage tube and role of surgery in
MPE, and key knowledge gaps that are the focus of ongoing research are also highlighted.
Keywords
malignant pleural effusion - mesothelioma - thoracic ultrasound - pleural biopsy -
indwelling pleural catheter - pleurodesis
