Black pleural effusion as the presenting feature of lung cancer.

Fernandes, Vera Luiza Capelozzi Delmonte; Alfaro, Tiago M.; Cruz, Cristiana; Cordeiro, Carlos Robalo

doi:10.1183/13993003.congress-2018.pa4113

Cited by 4 publications

(9 citation statements)

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“…[8,20,24,31,37] We also found a recurrence rate of 52%, ranging from 24 hours to 2 years since the initial BPE drainage. [8,12,14,18,19,22,23,25,27,29,34,35,37] This adds to the healthcare burden secondary to BPE. Although rare, BPE should be of particular concern as the mortality rate seems higher than the patients admitted with empyema (15%).…”

Section: Discussionsupporting

confidence: 51%

“…On the other hand, 4 (18.18%) out of 22 men died. Duration of symptoms to death varied from 21 days to 172 days [8,20,24,31,37] . Five (71.43%) women and 9 (52.9%) men were discharged home.…”

Section: Resultsmentioning

confidence: 99%

“…Two patients had bilateral, 2 had left, and only 1 had a right-sided BPE. [8,20,24,31,37] After initial drainage, recurrence of black effusion was seen in 2 patients, both with malignancy. [8,37] All 5 patients had an exudative effusion.…”

Section: Outcomes/prognosismentioning

confidence: 99%

“…Duration of symptoms to death varied from 21 days to 172 days. [8,20,24,31,37] Five (71.43%) women and 9 (52.9%) men were discharged home. The recurrence rate was similar in men and women.…”

Section: Interventions and Outcomesmentioning

confidence: 99%

“…[8,20,24,31,37] After initial drainage, recurrence of black effusion was seen in 2 patients, both with malignancy. [8,37] All 5 patients had an exudative effusion. Antibiotics were given to 2 patients (40%) who had a concurrent infection.…”

Section: Outcomes/prognosismentioning

confidence: 99%

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Etiology, pathological characteristics, and clinical management of black pleural effusion

et al. 2022

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Background: Pleural effusion is characterized by excessive fluid collection in the pleural cavity. Black pleural effusion (BPE) is a rare entity with only limited scientific data. We aimed to review the current literature on black pleural effusion to characterize demographics, etiology, clinical presentation, pathological findings, available treatment strategies, and prognosis of this rare condition.Methods: We performed a systematic review of case reports and series and synthesized data on demographics, manifestations, management, and outcomes of patients with BPE. We searched Cochrane Library, PubMed, SCOPUS, and Google Scholar for any date until January 10, 2021. All studies (n = 31) that reported black pleural effusion in patients were added to the review. Prospective Register of Systematic Reviews registration number: CRD42020213839. Summary and descriptive analysis was performed on Jamovi version 1.2.Results: The mean age of 32 patients with BPE was 53 years, with male predominance (69%). The commonest risk factor was smoking (n = 9) followed by alcohol intake (n = 8). Dyspnea was the commonest symptom (n = 24, 75%). Pleural fluid was mostly exudative (n = 21). The commonest associated diagnosis was malignancy (n = 14), with 50% secondary to metastatic melanoma. The commonest intervention was therapeutic thoracocentesis (n = 25, 78%), and the effusion recurred in half of the cases where recurrence was reported (n = 13). In our review, we found the mortality rate to be at 20.8% (n = 20.8%). 58.3% of the patients were successfully treated and discharged home (n = 14). Conclusion:Although rare, BPE appears to be a relevant symptom as it seems to be frequently associated with modifiable risk factors and underlying malignancy. Our systematic review substantiates a vital research gap as observational research is imperative to characterize BPE further and form a basis for designing tailored diagnostic, preventive, and therapeutic strategies for BPE.Abbreviations: BPE = black pleural effusion, PNSCC = pulmonary non-small cell carcinoma, PROSPERO = Prospective Register of Systematic Reviews.

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Section: Discussionsupporting

confidence: 51%

Section: Resultsmentioning

confidence: 99%

Section: Outcomes/prognosismentioning

confidence: 99%

Section: Interventions and Outcomesmentioning

confidence: 99%

Section: Outcomes/prognosismentioning

confidence: 99%

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Etiology, pathological characteristics, and clinical management of black pleural effusion

et al. 2022

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Brown‐Colored Malignant Pleural Fluid With High Bilirubin Levels: A Case Series

Huan,

Nyanti,

Lee

et al. 2024

Case Reports in Pulmonology

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Brown‐colored pleural effusion is rare and may result from high bilirubin levels such as bilothorax (often described as a pleural fluid‐to‐serum bilirubin ratio of > 1.0). We describe four patients with malignant pleural effusion that appeared macroscopically brown with a pleural fluid‐to‐serum bilirubin ratio between 3.7 and 16.2. All had metastatic adenocarcinomas; three were from lung and one from gastric origin. None demonstrated clear pleurobiliary fistulas on investigations. Postulates for the development of brown effusion include heme oxygenase 1 overexpression in malignant cells situated in the pleura, intrapleural hemolysis, passive movement of bile through microscopic diaphragmatic pores, and drainage of biliary fluid into the pleural lymphatics.

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