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Although malignant effusions are well established as a sign of advanced disease and poor prognosis, the implications of nonmalignant pleural effusions (NMPEs) are not well characterized. Investigators in England examined 774 patients who presented to the pleural service of an academic respiratory unit with “undiagnosed” pleural effusions during a 7-year period. All patients underwent thoracentesis with standard biochemical, cytologic, and infectious evaluations. Among these cases, 418 were associated with malignancy, and 356 patients had NMPEs.
Most NMPEs (73%) were exudative, and 88% of NMPEs were unilateral. Pulmonary infection was the most common cause of NMPE (41%). Somewhat unexpectedly, 35% of heart failure patients had exudative effus…