Pleural effusion, also called water on the lung, is an excessive build-up of fluid in the space between your lungs and chest cavity. Common symptoms of pleural effusion include shortness of breath, cough, chest pain or persistent hiccups.


What causes fluid build-up in the chest?

There is always a small amount of fluid within the linings of the lung to help lubricate the lungs as they expand within the chest during breathing.

Certain types of cancer can involve pleura (lining of the lungs) and cause a pleural effusion. Common cancers causing pleural effusions are lung cancer and mesothelioma. Other cancers such as breast, bowel and ovarian cancers can also cause pleural effusion.

Mesothelioma is a rare and aggressive cancer that develops in the lining around the lungs, abdomen, and heart. It is caused by exposure to asbestos and can take between 20 and 50 years to develop.

Further information on mesothelioma can be found on the following link


Many medical conditions can also cause pleural effusions

Common causes include but not limited to the following

  • Congestive Heart Failure
  • Cirrhosis of the Liver
  • Pneumonia and other chest infections
  • Severely Kidney disease
  • Other autoimmune conditions

Your doctor will explain to you if the effusion is due to any of these conditions and if you need further work-up to diagnose


Diagnosing Pleural Effusion

Your doctor will perform a physical examination and listen to your chest. A common test to diagnose pleural effusion is a plain X Ray of the chest or a CT scan of the chest.

If you are diagnosed with a pleural effusion but unable to be told which type, then your doctor will organise further tests.



Pleural fluid is removed from your lung by inserting a needle into the chest cavity under local anaesthesia and often under the guidance of an ultrasound by an experienced radiologist. The fluid is sent to the laboratory for further analysis to determine the cause.


Pleural Biopsy

If the fluid examination does not provide any diagnosis or if your doctor requires further information, then a pleural biopsy may be recommended. Pleural biopsy involves taking a sample of the tissue from the pleural and often performed by a cardiothoracic surgeon by a procedure called VATS (Video-Assisted Thoracoscopy). VATS is a minimally invasive surgical procedure to diagnose and treat various lung conditions. During VATs, a tiny camera with a light source is inserted through a small incision between the ribs. A second small incision is used to insert special instruments between the ribs into the chest cavity. This procedure allows smaller hospital stay (average 3-4 days) and quicker recovery than traditional thoracic surgery with a larger incision.


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