How do you evaluate a suspicious, but negative pleural effusion when working up NSCLC and SCLC?

Are two negative pleurocentesis' adequate to conclude that the patient does not have metastatic disease? Do you routinely recommend VATS and pleural biopsy? What if the effusion is bloody or exudative (but negative)?

Answer from: Radiation Oncologist at Academic Institution

Good question and this came up in my practice very recently (NSCLC). Historically, clinical trials have required 2 negative taps for entry. The patient I had in clinic appeared to have a node negative, LLL lesion with a ton of atelectasis and had a bloody tap that was negative for malignancy. It did...

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Radiation Oncologist at Stanford University
If there is no other explanation of the effusion a...

Medical Oncologist at Texas Oncology
If the effusion is still negative after 2 taps, I ...

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How do you evaluate a suspicious, but negative pleural effusion when working up NSCLC and SCLC?

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