Paramalignant pleural effusions and malignant pleural effusions are often used interchangeably which is wrong, these are two different types of pleural effusions, Said Dr. Kausar Rehanna, assistant professor of the department of pulmonology, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.


Paramalignant and malignant pleural effusions both occur in the presence of a solid tumor, but In case of a malignant effusion, there is direct pleural involvement and pleural fluid cytology shows malignant cells, therefore, an effusion which occurs as a result of metastatic pleural involvement and contains malignant cells is called a malignant effusion.

 On the other hand, a paramalignant effusion does not contain malignant cells, it occurs as a result of complication of malignancy, such as hypoalbuminemia due to malnutrition or lymphatic obstruction etc. there is no pleural involvement in case of a para-malignant pleural effusion and the pleural fluid cytology doesn’t show any malignant cell, a malignant effusion is usually exudative, but a para-malignant effusion can be a transudate or an exudate. 

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