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1

Kiselevsky, Mikhail V., ed. Malignant Effusions. Springer Netherlands, 2012. http://dx.doi.org/10.1007/978-94-007-4783-8.

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2

Tao, Liang-Che. Cytopathology of malignant effusions. ASCP Press, 1996.

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3

Boyce, Julian. Lactate dehydrogenase isoenzymes in malignant serous effusions. The Author], 1989.

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4

O'Hara, Susan R. Mucin histochemistry and immunohistochemistry: Their role in the distinction of malignant mesothelioma from adenocarcinoma in cell blocks of effusions. The Author], 1992.

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5

Blasi, Francesco, and Paolo Tarsia. Pathophysiology and causes of haemoptysis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0126.

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The main goal of management of pleural effusion is to provide symptomatic relief removing fluid from pleural space and the options depend on type, stage and underlying disease. The first diagnostic instrument is the chest radiography while ultrasound can be very useful to guide thoracentesis. Pleural effusion can be a transudate or an exudate. Generally a transudate is uncomplicated effusion treated by medical therapy, while an exudative effusion is considered complicated effusion and should be managed by drainage. Refractory non-malignant effusions can be transudative (congestive heart failur
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6

J C. (Ed.) Ruckdeschel. Malignant Pleural Effusions. Bristol Myers Squibb Company, 1992.

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7

Kiselevsky, Mikhail V. Malignant Effusions: Pleuritis, Ascites, Pericardites. Springer Netherlands, 2014.

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8

Kiselevsky, Mikhail V. Malignant Effusions: Pleuritis, Ascites, Pericardites. Springer, 2012.

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9

Kiselevsky, Mikhail V. Malignant Effusions: Pleuritis, Ascites, Pericardites. Springer, 2012.

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10

Kiselevsky, Mikhail V. Malignant Effusions: Pleuritis, Ascites, Pericardites. Springer London, Limited, 2012.

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11

Malignant effusions: A multimodal approach to cytologic diagnosis. Igaku-Shoin, 1994.

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12

Cronin, William John. Reactivity of antibodies isolated from immune complexes present in malignant effusions. 1988.

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13

Choong, Cliff K. C. Management of Benign and Malignant Pleural Effusions, an Issue of Thoracic Surgery Clinics. Elsevier, 2013.

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14

Schomberg, Lucy, and Nick Maskell. Water on the lung: a rare cause of a transudative effusion and new options for palliation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0016.

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Pleural effusions are very common in clinical practice and can be notoriously difficult to diagnose and a real challenge to manage. There is a large amount of literature on malignant effusions, but no clear guidelines on managing refractory non-malignant pleural effusions. This case examines a rarer cause of a transudative effusion, focussing on the route to diagnosis. The emergence of thoracic ultrasound, in light of the National Patient Safety Agency report in 2008, and the increased safety are reviewed, and, in addition, the options for management are considered, including the tunnelled ple
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15

Grundy, Seamus. Pleural infection and malignancy. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0143.

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Pleural infection transitions from simple parapneumonic effusion, to complex parapneumonic effusion, to empyema. Primary empyema occurs without an underlying pneumonic process. Pleural infection commonly presents identically to pneumonia with dyspnoea, purulent sputum, and fevers. It may be associated with pleuritic chest pain. Empyema can cause systemic sepsis, leading to cardiovascular instability and multi-organ failure. A malignant pleural effusion arises when malignant cells infiltrate the pleura, resulting in increased production and decreased lymphatic drainage of pleural fluid. Maligna
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16

Chiumello, Davide, and Silvia Coppola. Management of pleural effusion and haemothorax. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0125.

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The main goal of management of pleural effusion is to provide symptomatic relief removing fluid from the pleural space. The options depend on type, stage, and underlying disease. The first diagnostic instrument is the chest radiography, while ultrasound can be very useful to guide thoracentesis. Pleural effusion can be a transudate or an exudate. Generally, a transudate is uncomplicated effusion treated by medical therapy, while an exudative effusion is considered complicated effusion and should be managed by drainage. Refractory non-malignant effusions can be transudative (congestive heart fa
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