ABSTRACT
Pleural effusions accompanying malignant disease pose a common diagnostic and therapeutic problem. Three types of neoplasms (lung and breast cancer and the lymphomas) account for 75% of secondary malignant effusions. Rarely, a tumour-associated effusion may not be due to direct involvement of the pleura by the malignancy (paramalignant effusion). The main symptoms are dyspnoea and dull chest pain, but 25% of cases may be asymptomatic at