Diagnosis and outcome of patients with idiopathic pleural effusions

Abstract

Introduction: Long-term follow-up course for patients with idiopathic pleural effusions has not been established.

Methods: From October 2013 to June 2021 all patients with idiopathic effusion were prospectively followed up with clinical examination and imaging at 1, 3, 6 and every 6 months for a minimum of 1 year.

Results: Twenty-nine patients were diagnosed with idiopathic effusion and followed up. Mesothelioma was detected during the follow-up in two patients at 7 and 18 months, one of whom had blood-tinged pleural fluid and the other reported a 10% weight loss. Mesothelioma was not diagnosed in any of the patients with effusion covering less than two thirds of the hemithorax, and without constitutional symptoms or a blood-tinged fluid appearance. Most of the effusions resolved or showed a clear improvement in the first six months.

Conclusion: Patients without weight loss and with small, non-hematic effusions, may benefit from conservative treatment and clinical-radiological follow-up.

Keywords: Benign pleural effusion; Derrame idiopático; Derrame pleural benigno; Idiopathic effusion; Mesotelioma; Mesothelioma.