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Pleural Effusion vs ????

Guest Piermarie

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Guest Piermarie

Hi all,

Had to bring my mom in for another CT yesterday of her chest since she was having sharp pains in her right lower chest especially with deep breaths. The doctor wanted to rule out Pulmonary embolism although we know that she has fluid at the base of her rt. lung. That fluid showed a slight increase at the beginning of the month with her regular CT.

I had wanted them to remove the fluid then, but the dr. felt since she was having no symptoms, why do any type of procedure. I agreed at the time but now I really feel as though it should be taken out.

Her catscan yesterday showed only a slight increase in the fluid with everything else being stable. The onc. wants us to just wait and see how she feels in a few days of taking motrin and/or Tylenol. So far, when she takes the motrin, she has no pain but once it wears off, it's still there.

I told her dr. that we would wait till the end of the weekend and if there is no improvement, I would like a pulmonologist to evaluate her for an aspiration of the fluid.

In response to the other questions of malignancy in pleural effusions, I've heard also that it can be either or. The onc. tells us that they "assume" it's malignant unless they know otherwise with a pathology test. As to whether or not it makes a difference in the scheme of things, I don't know but plan to ask him.

If anyone has any more experience with pleural effusion...I'm all EARS/EYES!!!!



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Well I'm afraid I have no answers for you but I also have the same questions right now. I think my signature should show up below so you can see what my dad's situation has been up to now but....I just posted a few days ago regarding clean pet scan for him and he is IIIB. Well the other part of that story which I thought had been put to rest, was that his doctor stumbled upon a pleural effusion he had on a CT scan(now a month ago) before this PET Scan. They were just doing this CT scan to see if his chemo had done the job for him. They could see no evidence of a tumor and the lymph nodes were not visible at all. So this began the now months worth of testing trying to figure out why this fluid was there. They had since drained it, about two weeks ago and it tested negative for cancer cells. They did a bronchoscopy with 19 different samples of tissue, all of them came back negative for cancer and his PET scan came back clean. We were praising/thanking God!!!!

But it doesn't seem to be over yet...........They are on a mission to prove that this fluid is cancerous. He is now set up for a Medianoscopy, and thoroscopy (scoping of the pleural area) and if all goes well :roll: with that in the same procedure (a three step surgery) they will resect the lower lobe of the lung which by all pathological accounts is necrotic. So basically we will walk away from that surgery date either stage 0 or stage 4; how ironic is that!!!

Obviously, I have no good answers for you and for this I'm sorry. It only seems to bring up more questions. These effusions are so damned tricky and apparently not completely easy to diagnose. I will let you know if I find out any solid information about pleural effusions in the meantime and please do the same if you would. We are obviously sittin' on pins and needles here because we thought we had remission in our grasp; but not quite yet!!!!! My prayers are w/you because I know all to well how you feel.


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Dear PierMarie,

I have a malignant pleural effusion. In fact, that is how they diagnosed my cancer. The tumor showed up on a ct scan and I had (at the time) a very small effusion. So they took a small amount of the fluid, apparently they did not need much, because it tested positive for tumor cells. I never had to have a broncoscopy or any other invasive procedures.

I am coming up on my 1 year anniversary date of diagnosis, April 10th and I have had the fluid drained 4 times. On Monday, it looks like they will be inserting a Denver Cathetar so that I can drain the fluid myself every other day. My last x-rays showed the fluid was almost up to the top of my lung. There is alot in there.

If your mom only has a very small effusion, I agree that they should just watch it. Sometimes it is very risky to do a thorencentesis with only a small amount of fluid. And since she has other mets, it would not change their course of treatment. No since in putting her through a procedure. They say it is supposed to be an "easy" procedure, but believe me, I have had plenty of problems with it. (The first time I had it done I fainted!)

Please feel free to PM me if you would like more information. I find I am learning more that I ever though I would about this terrible disease!


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