A note on ultrasound in malignant pleural effusion

Ultrasound has a sensitivity of 73% and specificity of 100% at distinguishing malignant pleural effusions from other causes of pleural effusion, based on the presence of

• visible pleural metastases,
• pleural thickening greater than 1 cm,
• pleural nodularity,
• diaphragmatic thickening measuring greater than 7mm and
• an echogenic swirling pattern visible in the pleural fluid.

References:

1. Qureshi NR, Rahman NM, Gleeson FV (February 2009). "Thoracic ultrasound in the diagnosis of malignant pleural effusion". Thorax 64 (2): 139–43.

2. Chian CF, Su WL, Soh LH, Yan HC, Perng WC, Wu CP (July 2004). "Echogenic swirling pattern as a predictor of malignant pleural effusions in patients with malignancies". Chest 126 (1): 129–34