Advances in pleural infection and malignancy

Eihab O Bedawi, Julien Guinde, Najiib M Rahman, Philippe Astoul, Eihab O Bedawi, Julien Guinde, Najiib M Rahman, Philippe Astoul

Abstract

Pleural infection and malignancy are among the most common causes of pleural disease and form the mainstay of pleural practice. There has been significant research and increase in scientific understanding in these areas in the past decade. With regard to pleural infection, the rising incidence remains worrying. An increased awareness allowing earlier diagnosis, earlier escalation of therapy and the use of validated risk stratification measures may improve outcomes. In pleural malignancy, research has enabled clinicians to streamline patient pathways with focus on reducing time to diagnosis, definitive management of malignant pleural effusion and achieving these with the minimum number of pleural interventions. Trials comparing treatment modalities of malignant pleural effusion continue to highlight the importance of patient choice in clinical decision-making. This article aims to summarise some of the most recent literature informing current practice in these two areas.

Conflict of interest statement

Conflict of interest: E.O. Bedawi has nothing to disclose. Conflict of interest: J. Guinde has nothing to disclose. Conflict of interest: N.M. Rahman reports grants from Roche and Genentech, and grants and personal fees from LTI USA, outside the submitted work. Conflict of interest: P. Astoul has nothing to disclose.

Copyright ©ERS 2021.

Figures

FIGURE 1
FIGURE 1
Real-time ultrasound-guided cutting-needle biopsy.
FIGURE 2
FIGURE 2
A practical algorithm for the management of malignant pleural effusion. IPC: indwelling pleural catheter; LENT: pleural lactate dehydrogenase rate, neutrophil-to-lymphocyte ratio, tumour type and Eastern Cooperative Oncology Group performance status.

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Source: PubMed

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