Persistent benign pleural effusion

Our plain-English summary of Persistent benign pleural effusion, by J.M. Porcel (Revista Clínica Española, 2017).

The study

• Author: J.M. Porcel
• Journal: Revista Clínica Española
• Published: 2017;217(6):336-341
• Language: Spanish
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In this narrative review we describe the main aetiologies, clinical characteristics and treatment for patients with benign pleural effusion that characteristically persists over time: chylothorax and cholesterol effusions, nonexpansible lung, rheumatoid pleural effusion, tuberculous empyema, benign asbestos pleural effusion and yellow nail syndrome.

Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

In plain English

This article was a narrative review, written in Spanish by a single author from a pleural medicine unit in Lleida, Spain. It described the main causes, clinical features and treatment of benign (non-cancerous) fluid build-up around the lungs, called pleural effusions, of types that tend to persist over time. These were chylothorax and cholesterol effusions, non-expansible lung, rheumatoid pleural effusion, tuberculous empyema, benign asbestos pleural effusion and yellow nail syndrome. It reported no new patient data of its own. Its section on benign asbestos pleural effusion summarized a recent Japanese series of 110 patients published by other researchers. In that series all patients were men. The effusion was mostly on one side (75%), and 40% were found by chance in people without symptoms. All but one had a history of occupational asbestos exposure (one exposure was environmental), a median of 48 years before diagnosis. Most also had other asbestos-related findings on imaging, including pleural plaques (90%) and asbestosis (6%). The author wrote that diagnosing this condition always requires excluding other causes such as mesothelioma, lung cancer or tuberculosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review (no original data)
• Who was studied: Not a study of a patient group. The review covered published literature on several types of persistent benign pleural effusion. For benign asbestos pleural effusion it summarized a Japanese series of 110 patients reported by other researchers (Fujimoto et al., 2015).
• Exposure: Asbestos exposure, as the cause of benign asbestos pleural effusion (one of several topics covered). No fiber types, products or doses were named.
• Main results:
  • The review cited a recent Japanese series (another study, not this one) that described 110 patients with benign asbestos pleural effusion.
  • In that cited Japanese series all patients were men. The effusion was mostly on one side (75%), and in 40% of cases it was found by chance in a person without symptoms.
  • In the cited series, all patients had a history of occupational asbestos exposure, except one case in which the exposure was environmental.
  • In the cited series, exposure occurred a median of 48 years (interquartile range 17 to 76 years) before the diagnosis of benign asbestos pleural effusion.
  • In the cited series, the effusions were exudates (fluid of the inflammatory type), generally with a predominance of lymphocytes.
  • In the cited series, most patients had other imaging findings typical of asbestos exposure, including pleural plaques (90%).
  • Other imaging findings in the cited series were round atelectasis (37%), diffuse pleural thickening (27%) and asbestosis (6%).
  • The author stated that diagnosing benign asbestos pleural effusion in a person with an exudative effusion and a history of asbestos exposure always requires excluding other causes such as mesothelioma, lung cancer or tuberculosis.
  • The review noted that follow-up of these patients every 1 to 3 years with chest X-ray and lung function tests is recommended. This recommendation was cited to separate Spanish guidance.
• The authors' conclusion: The review did not include a separate overall conclusion.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Effusion, Empyema, Benign Asbestos Pleural Effusion.

Related studies

• Pleurectomy for persistent pain in benign asbestos-related pleural disease — D.I. Fielding, J.L. McKeon, et al. (1995)
• Prevalence and incidence of benign asbestos pleural effusion in a working population — G.R. Epler, T.C. McLoud, et al. (1982)
• MicroRNA and mRNA features of malignant pleural mesothelioma and benign asbestos-related pleural effusion — G. Ak, S.C. Tomaszek, et al. (2015)
• Benign asbestos pleural effusion: diagnosis and course — B.W. Robinson, A.W. Musk (1981)
• IMP3/L523S, a novel immunocytochemical marker that distinguishes benign and malignant cells: the expression profiles of IMP3/L523S in effusion cytology — K. Ikeda, G. Tate, et al. (2010)
• The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion — Y. Sun, H. Yu, et al. (2016)

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