Table 2—

Causes of paramalignant pleural effusions

Local effects of tumour
 Lymphatic obstructionPredominant mechanism for pleural fluid accumulation
 Bronchial obstruction with pneumoniaParaneumonic effusion; does not exclude operability in lung cancer
 Bronchial obstruction with atelectasisTransudate; does not exclude operability in lung cancer
 Trapped lungTransudate; due to extensive tumour involvement of visceral pleura
 ChylothoraxDisruption of thoracic duct; lymphoma most common cause
 Superior vena cava syndromeTransudate; due to increased systemic venous pressure
Systemic effects of tumour
 Pulmonary embolismHypercoagulable state
 HypoalburninemiaSerum albumin <1.5 g·dL−1; associated with anasarca
Complications of therapy
 Radiation therapy
  EarlyPleuritis 6 weeks to 6 months after radiation completed
  LateFibrosis of mediastinum
Constrictive perficarditis
Vena caval obstruction
  MethotrexatePleuritis or effustion; with or without blood eosinophilia
  ProcarbazineBlood eosinophilia; fever and chills
  Mitomycin/bleomycinIn association with interstitial disease