الفهرس 
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Abstract
Malignant pleural effusion (MPE) is defined by the accumulation of fluid in the presence of malignant cells or tumor tissue in the pleural space. It can occur either in the setting of a known and diagnosed primary tumor, or it can be the first presentation and metastasis of an unknown malignancy. An MPE is a sign of advanced stage illness and indicates a dismal prognosis overall, with a median survival of three to twelve months, contingent upon the kind of initial tumor (1).While a small percentage of patients may not exhibit any symptoms, most experience dyspnea during rest, which is linked to a worse quality of life.
The goal of management strategies for MPEs is still to relieve patient symptoms and reduce the need for more invasive procedures, even with advances in our understanding of the pathophysiology of these conditions and the remarkable progress made in cancer treatments in the past ten years (2).
Etiology
The majority of MPE result from metastatic spread to the pleura, predominantly due to lung and breast cancers (3). Lung cancer stands as the primary culprit for MPE, seen in about 15% of patients at the time of diagnosis and occurring in as many as 50% of patients during their illness trajectory. Adenocarcinomas are the most frequently encountered histological type leading to MPE (4). Following lung cancer, breast cancer is a significant contributor to MPE incidence. Approximately 70% of these effusions are found on the same side as the original tumor, and in 22.5% of cases with pleural effusions, a biopsy of the internal mammary nodes yields positive results (5).
Almost all hematological malignancies may, at times, manifest with or develop pleural effusions throughout their progression. Hodgkin and non-Hodgkin lymphomas are among the most frequently observed conditions, presenting in 20 to 30% of cases, particularly when the mediastinum is affected (6). Lymphomas stand out as the leading hematological malignancy linked to MPE, making up about 7% to 16% of all MPEs confirmed through cytology. Lymphoma patients with MPE often show involvement of the mediastinal lymph nodes.
In around 10% of cases with MPE, the initial tumor source remains unidentified. Malignant mesothelioma emerges as the most prevalent primary tumor of the pleura leading to MPE; its prevalence depends on the geographic area and is closely associated with asbestos exposure