Contemporary Approach to the Diagnosis of Malignant Pleural Effusion

Ann Am Thorac Soc. 2019 Sep;16(9):1099-1106. doi: 10.1513/AnnalsATS.201902-189CME.


Advanced malignancy is a prevalent cause of exudative pleural effusion. The management of malignant pleural effusion (MPE) has been the subject of several recent randomized controlled trials and excellent reviews. Less attention has been focused on another controversial and challenging aspect of MPE: establishing the diagnosis. Before selecting the optimal management strategy, the presence of an MPE must first be correctly identified with an emphasis on minimizing invasiveness and discomfort in a patient with late-stage cancer. The aim of the present review is to summarize the current knowledge about MPE diagnostics and to propose an algorithm for the diagnosis of MPE in established or suspected malignancy.

Keywords: approach; diagnosis; malignant pleural effusion.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Biomarkers, Tumor
  • Humans
  • Magnetic Resonance Imaging
  • Pleural Effusion, Malignant / diagnosis*
  • Positron Emission Tomography Computed Tomography
  • Radiography, Thoracic
  • Randomized Controlled Trials as Topic
  • Thoracoscopy


  • Biomarkers, Tumor