A pleural effusion is an unusual amount of fluid around the lung. There are many medical conditions that can lead to it, so even though a pleural effusion can be drained, only a doctor will be able to prescribe treatment.
The pleura is a thin membrane that lines the surface of the lungs and the inside of the chest wall outside the lungs. In pleural effusions, fluid collects in the space between the layers of pleura.
Normally, only teaspoons of watery fluid are in the pleural space, allowing the lungs to move smoothly within the chest cavity during breathing.
A wide range of things can cause a pleural effusion. Some of the most common are:
Leaks from other organs: This usually occurs from congestive heart failure (when your heart does not pump blood to your body correctly). But it can also come from liver or kidney disease when fluid builds up in your body and leaks into the pleural space.
Cancer: Lung cancer is usually the problem, but other cancers that have spread to the lung or pleura can cause it as well.
Infections: pneumonia or tuberculosis.
Autoimmune conditions: lupus or rheumatoid arthritis.
Pulmonary embolism: This is a blockage in an artery in one of your lungs.
You may not have any symptoms. You are more likely to have symptoms when a pleural effusion is moderate or large, or if inflammation is present.
If you have symptoms, it may include:
- Difficulty breathing.
- Chest pain, especially when breathing deeply (pleurisy or pleuritic pain).
- Fever.
- Cough.
Only a doctor will tell you the symptoms will do a physical exam. You will listen to the chest with a stethoscope and pound it. More often, doctors will confirm pleural effusions on imaging tests. It can be diagnosed through:
Chest X-ray: Pleural effusions appear white on chest X-rays, while the airspace appears black.
CT scan: A CT scan takes a lot of X-rays quickly, and a computer builds images of the entire chest - inside and out. CT scans show more details from chest x-rays.
Ultrasound: A probe in your chest will create pictures of the inside of your body, which appear on a video screen. It can be used to locate the fluid so your doctor can obtain a sample for analysis.
Also, your doctor may do something called thoracentesis. It will take some of the liquid to test it. To do this, you will insert a needle into a tube called a catheter between your ribs, in the pleural space.
