Management der malignen Pleuraergüsse

Zusammenfassung

Maligne Pleuraergüsse mit ihrem Hauptsymptom Atemnot sind ein häufiges Problem bei Patienten mit bösartigen Tumorerkrankungen. Verantwortlich führend ist der Lungenkrebs, gefolgt vom Mammakarzinom und den malignen Lymphomen. Die Häufigkeit des Pleuramesothelioms nimmt in den Industrieländern zu. In dieser Übersicht, die auf dem ERS/ATS-Statement 2001 basiert, werden das diagnostische Vorgehen, die Differenzialdiagnostik - einschließlich der Ursachen paramaligner Pleuraergüsse - und die therapeutischen Möglichkeiten aufgezeigt. Bei den lokalen Maßnahmen steht die Pleurodese im Vordergrund, heute vorzugsweise mittels thorakoskopischer Talkum-Puderung. Alternative lokale und systemische Behandlungsmöglichkeiten werden eingehend besprochen. Speziell wird auf die Epidemiologie, Diagnostik, Therapie und Prognose beim Lungenkarzinom, beim Mammakarzinom und bei den malignen Lymphomen eingegangen. Abschließend werden offene Fragen aufgezählt, die der zukünftigen Forschung bedürfen und hoffentlich die Therapie und Prognose der malignen Ergüsse verbessern werden.

Abstract

Malignant pleural effusions with dyspnoea as their most common presenting symptom are a frequent clinical problem in patients with neoplastic disease. Lung carcinoma is the leading cause, followed by breast carcinoma and malignant lymphoma. The frequency of malignant mesothelioma is increasing in industrialized countries. In this overview, which is based on the ERS/ATS Statement 2001, the diagnostic approach, the differential diagnosis including causes of paramalignant effusions, as well as the therapeutic possibilities are described. Pleurodesis is the most important therapeutic modality, today preferably via thoracoscopic talc poudrage. Alternative local and systemic treatment options are discussed in detail. A special emphasis is put on the epidemiology, diagnosis, treatment, and prognosis of malignant effusions in patients with lung and breast carcinomas, and with lymphomas. Finally, open questions are listed which need future research, which will hopefully improve the treatment and prognosis of malignant pleural effusions.

Literatur

• 1 Antony V B, Loddenkemper R, Astoul P. et al . Management of malignant pleural effusions.  Eur Respir J. 2001;  18 402-419
• 2 Rodriguez-Panadero F, Borderas Naranjo F, Lopez-Mejias J. Pleural metastatic tumours and effusions: frequency and pathogenic mechanisms in a post-mortem series.  Eur Respir J. 1989;  2 366-369
• 3 Cohen S, Hossain S. Primary carcinoma of the lung: a review of 417 histologically proved cases.  Dis Chest. 1966;  49 626-629
• 4 Emerson G L, Emerson M S, Sherwood C E. The natural history of carcinoma of the lung.  J Thorac Surg. 1959;  37 291-304
• 5 Apfelstaedt J P, Muller A G. Breast cancer complicated by pleural effusion.  J Surg Oncol. 1995;  58 173-175
• 6 Kreisman H, Wolkove N, Finkelstein H S. et al . Breast cancer and thoracic metastasis: review of 119 patients.  Thorax. 1983;  38 175-179
• 7 Weichselbaum R, Marck A, Hellman S. Pathogenesis of pleural effusion in carcinoma of the breast.  Int J Radiat Oncol Biol Phys. 1977;  2 963-965
• 8 Weick J K, Kiely J M, Harrison E G. et al . Pleural effusion in lymphoma.  Cancer. 1973;  31 848-853
• 9 Stenbygaard L E, Olsen J E. Metastatic pattern at autopsy in non-resectable adenocarcinoma of the lung.  Acta Oncol. 1997;  36 301-306
• 10 Stenbygaard L E, Sorensen J B, Olsen J E. Metastatic pattern in adenocarcinoma of the lung.  Thorac Cardiovas Surg. 1995;  110 1130-1135
• 11 Lee Y TN. Breast carcinoma: pattern of metastasis at autopsy.  J Surg Oncol. 1983;  23 175-180
• 12 Vieta J O, Craver L F. Intrathoracic manifestations of the lymphomatoid diseases.  Radiology. 1943;  37 138-159
• 13 Chernow B, Sahn S A. Carcinomatous involvement of the pleura: an analysis of 96 patients.  Am J Med. 1977;  63 695-702
• 14 Johnston W W. The malignant pleural effusion: a review of cytopathological diagnoses of 584 specimens from 472 consecutive patients.  Cancer. 1985;  56 905-909
• 15 Müller K M. Pleuramesotheliom - Pathologie und Pathogenese.  Pneumologie. 2004;  58 670-678
• 16 Hsu C. Cytologic detection of malignancy in pleural effusion: a review of 5,255 samples from 3,811 patients.  Diag Cytopathol. 1987;  3 8-12
• 17 Prakash U BS, Reiman H M. Comparison of needle biopsy with cytologic analysis for the evaluation of pleural effusions: analysis of 414 cases.  Mayo Clin Proc. 1985;  60 158-164
• 18 Molengraft F L, Vooijs G P. The interval between the diagnosis of malignancy and the development of effusions, with reference to the role of cytologic diagnosis.  Acta Cytol. 1988;  32 183-187
• 19 Parker S L, Tong T, Bolden S. Cancer statistics 1997.  CA Cancer J Clin. 1997;  47 5-27
• 20 Marel M, Zrustova M, Stasny B. et al . The incidence of pleural effusion in a well-defined region: epidemiologic study in central Bohemia.  Chest. 1993;  104 1486-1489
• 21 Valdes L, Alvarez D, Valle J M. et al . The aetiology of pleural effusions in an area with high incidence of tuberculosis.  Chest. 1996;  109 158-162
• 22 Meyer P C. Metastatic carcinoma of the pleura.  Thorax. 1966;  21 437-443
• 23 Andrews B S, Arora N S, Shadforth M F. et al . The role of immune complexes in the pathogenesis of pleural effusions.  Am Rev Respir Dis. 1981;  124 115-120
• 24 Sahn S A. Pleural diseases related to metastatic malignancies.  Eur Respir J. 1997;  10 1907-1913
• 25 Estenne M, Yernault J C, De Troyer A. Mechanism of relief of dyspnoea after thoracentesis in patients with large pleural effusions.  Am J Med. 1983;  74 813-819
• 26 Tammilebto L, Maasilita P, Kostianen S. Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients.  Respiration. 1992;  52 129-135
• 27 Bittner R C. Bildgebende Diagnostik bei Pleuraerkrankungen.  Pneumologie. 2004;  58 238-254
• 28 Maher G G, Berger H W. Massive pleural effusions: malignant and nonmalignant causes in 46 patients.  Am Rev Respir Dis. 1972;  105 458-460
• 29 O'Donovan P B, Eng P. Pleural changes in malignant pleural effusions: appearance on computed tomography.  Cleve Clin J Med. 1994;  61 127-131
• 30 Grogan D R, Irwin R S, Channick R. Complications associated with thoracentesis: a prospective randomized study comparing three different methods.  Arch Intern Med. 1990;  150 873-877
• 31 Patz E F, Shaffer K, Piwnica-Worms D R. et al . Malignant pleural mesothelioma: value of CT and MRI imaging in predicting resectability.  Am J Roentgenol. 1992;  159 961-966
• 32 Carlsen S E, Bergin C J, Hoppe R T. MR imaging to detect chest wall and pleural involvement in patients with lymphoma: effect on radiation therapy planning.  Am J Roentgenol. 1993;  160 191-195
• 33 Bittner R C, Felix R. Magnetic resonance (MR) imaging of the chest: state of the art.  Eur Respir J. 1998;  11 1392-1404
• 34 Benard F, Sterman D, Smith R J. et al . Metabolic imaging of malignant pleural mesothelioma with fluorodeoxyglucose positron emission tomography.  Chest. 1998;  144 713-722
• 35 Frank W. Diagnostisches Vorgehen beim Pleuraerguss.  Pneumologie. 2004;  58 777-790
• 36 McVay P A, Toy P T. Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities.  Transfusion. 1991;  31 164-171
• 37 Light R W, MacGregor M I, Luchsinger P C. et al . Pleural effusions: the separation of transudates and exudates.  Ann Intern Med. 1972;  77 507-513
• 38 Heffner J E, Brown L K, Barbieri C A. Diagnostic value of tests that discriminate between exudative and transudative pleural effusions.  Chest. 1997;  111 970-980
• 39 Clarkson B. Relationship between cell type, glucose concentration, and response to treatment in neoplastic effusions.  Cancer. 1964;  17 914-928
• 40 Roth B J, O'Meara T F, Cragun W H. The serum-effusion albumin gradient in the evaluation of pleural effusions.  Chest. 1990;  98 546-554
• 41 Light R W, Erozan Y S, Ball W C. Cells in pleural fluid: their value in differential diagnosis.  Arch Intern Med. 1973;  132 854-860
• 42 Yam L T. Diagnostic significance of lymphocytes in pleural effusions.  Ann Intern Med. 1967;  66 972-982
• 43 Adelman M, Albelda S M, Gottlieb J. et al . Diagnostic utility of pleural eosinophilia.  Am J Med. 1984;  77 915-920
• 44 Rubins J B, Rubins H B. Aetiology and prognostic significance of eosinophilic pleural effusions. A prospective study.  Chest. 1996;  110 1271-1274
• 45 Sahn S A, Good Jr J T. Pleural fluid pH in malignant effusions: diagnostic, prognostic, and therapeutic implications.  Ann Intern Med. 1988;  108 345-349
• 46 Sanchez-Armengol A, Rodriguez-Panadero F. Survival and talc pleurodesis in metastatic pleural carcinoma, revisited.  Chest. 1993;  104 1482-1485
• 47 Rodriguez-Panadero F, Lopez-Mejias L. Low glucose and pH levels in malignant effusions. Diagnostic significance and prognostic value in respect to pleurodesis.  Am Rev Respir Dis. 1989;  139 663-667
• 48 Good J T, Taryle D A, Sahn S A. The pathogenesis of low glucose, low pH malignant effusions.  Am Rev Respir Dis. 1985;  131 737-741
• 49 Rodriguez-Panadero F, Lopez-Mejias L. Survival time of patients with pleural metastatic carcinoma predicted by glucose and pH studies.  Chest. 1989;  95 320-324
• 50 Foresti V, Scolari N, Villa A. et al . Malignant pleural effusions: meaning of pleural-fluid pH determination.  Oncology. 1990;  47 62-64
• 51 Foresti V. Intrapleural Corynebacterium parvum for recurrent malignant pleural effusions.  Respiration. 1995;  62 21-26
• 52 Martinez-Moragon E, Aparicio J, Sanchis J. et al . Malignant pleural effusions: prognostic factors for survival and response to chemical pleurodesis in a series of 120 cases.  Respiration. 1998;  65 108-113
• 53 Aelony Y, King R R, Boutin C. Thoracoscopic talc poudrage in malignant pleural effusions: effective pleurodesis despite low pleural pH.  Chest. 1998;  113 1007-1012
• 54 Bilaceroglu S, Cagirici U, Permin K. et al . Corynebacterium parvum pleurodesis and survival is not significantly influenced by pleural pH and glucose level.  Monaldi Arch Chest Dis. 1998;  53 14-22
• 55 Heffner J E, Nietert P J, Barbieri C. Pleural fluid pH as a predictor of survival for patients with malignant pleural effusions.  Chest. 2000;  117 79-86
• 56 Heffner J E, Nietert P J, Barbieri C. Pleural fluid pH as a predictor of pleurodesis failure.  Chest. 2000;  117 87-95
• 57 Burrows C M, Mathew W C, Colt H G. Predicting survival in patients with recurrent symptomatic malignant pleural effusions.  Chest. 2000;  117 73-78
• 58 Joseph J, Vuney S, Beck P. et al . A prospective study of amylase-rich pleural effusions with special reference to amylase isoenzyme analysis.  Chest. 1992;  102 1455-1459
• 59 Krammer M R, Saldana M J, Cepro R J. High amylase in neoplasm-related pleural effusion.  Ann Intern Med. 1989;  10 567-569
• 60 Hillerdal G, Lindqvist U, Engstrom-Laurent A. Hyaluronan in pleural effusions and in serum.  Cancer. 1991;  67 2410-2414
• 61 Starr R L, Sherman M E. The value of multiple preparations in the diagnosis of malignant pleural effusions.  Acta Cytol. 1991;  35 533-537
• 62 Loddenkemper R, Grosser H, Gabler A. et al . Prospective evaluation of biopsy methods in the diagnosis of malignant pleural effusions: intrapatient comparison between pleural fluid cytology, blind needle biopsy and thoracoscopy.  Am Rev Respir Dis. 1983;  127 (Suppl. 4) 114
• 63 Rijken A, Dekker A, Taylor S. et al . Diagnostic value of DNA analysis in effusions by flow cytometry and image analysis.  Am J Clin Pathol. 1991;  95 6-12
• 64 Mentintas M, Ozdemir N, Solak M. et al . Chromosome analysis in pleural effusions: efficiency of this method in the differential diagnosis of pleural effusions.  Respiration. 1994;  61 330-335
• 65 Sheibani K, Esteban J, Bailey A. et al . Immunopathologic and molecular studies as an aid to the diagnosis of malignant mesothelioma.  Hum Pathol. 1992;  23 107-116
• 66 Shield P W, Callan J J, Devine P L. Markers for metastatic adenocarcinoma in serous effusion specimens.  Diag Cytol. 1994;  11 237-245
• 67 Singh H K, Silverman J F, Berns L. et al . Significance of epithelial membrane antigen in the work-up of problematic serous effusions.  Diag Cytopathol. 1995;  13 3-7
• 68 Mezger J, Stotzer O, Schilli G. et al . Identification of carcinoma cells in ascitic and pleural fluid: comparison of four panepithelial antigens with carcinoembryonic antigen.  Acta Cytol. 1992;  36 758-781
• 69 Chen C J, Chang S C, Tseng H H. Assessment of immunocytochemical and histochemical stainings in the distinction between reactive mesothelial cells and adenocarcinoma cells in body effusions.  Chin Med J. 1994;  54 149-155
• 70 Ghosh A K, Spriggs A I, Taylor-Papadimitriou J. et al . Immunocytochemical staining of cells in pleural and peritoneal effusion with a panel of monoclonal antibodies.  J Clin Pathol. 1983;  36 1154-1164
• 71 Athanassiadou P, Athanassiades P, Lazaris D. et al . Immunocytochemical differentiation of reactive mesothelial cells and adenocarcinoma cells in serous effusions with the use of CEA and fibronectin.  Acta Cytol. 1994;  38 718-722
• 72 Maguire B, Whitaker D, Carrello S. et al . Monoclonal antibody Ber-EP4: its use in the differential diagnosis of malignant mesothelioma and carcinoma in cell blocks of malignant effusions and FNA specimens.  Diag Cytopathol. 1994;  10 130-134
• 73 Yang P C, Luh K T, Kuo S H. et al . Immunocytochemistry and ELISA quantitation of mucin for diagnosis of malignant pleural effusions.  Am Rev Respir Dis. 1992;  164 1571-1575
• 74 Kortsik C S, Werner P, Freudenberg N. et al . Immunocytochemical characterization of malignant mesothelioma and carcinoma metastatic to the pleura: IOB3 - a new tumor marker.  Lung. 1995;  173 79-87
• 75 Shijubo N, Honda Y, Fujishima T. et al . Lung surfactant protein-A and CEA in pleural effusions due to lung adenocarcinoma and malignant mesothelioma.  Eur Respir J. 1995;  8 403-406
• 76 Poe R H, Israel R H, Utell M J. et al . Sensitivity, specificity, and predictive values of closed needle biopsy.  Arch Intern Med. 1984;  144 325-328
• 77 Escudero B C, Garcia C M, Cuesta C B. et al . Cytological and bacteriologic analysis of fluid and pleural biopsy specimens with Cope's needle.  Arch Intern Med. 1990;  150 1190-1194
• 78 Beauchamp H D, Kundra N K, Aranson R. et al . The role of closed needle biopsy in the diagnosis of malignant mesothelioma of the pleura.  Chest. 1992;  102 1110-1112
• 79 Maskell N A, Gleeson F V, Davies R JO. Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial.  Lancet. 2003;  361 1325-1330
• 80 Canto A, Rivis J, Saumench J. et al . Points to consider when choosing a biopsy method in cases of pleurisy of unknown origin.  Chest. 1983;  84 176-179
• 81 Sahn S A. Thoracentesis and pleural biopsy. In: Shelhamer J, Pizzo PA, Parillo JE, Masur H (eds). Respiratory disease in the immunosuppressed host. Philadelphia: JB Lippincott 1991
• 82 Loddenkemper R, Boutin C. Thoracoscopy: diagnostic and therapeutic indications.  Eur Respir J. 1993;  6 1544-1555
• 83 Harris R J, Kavuru M S, Rice T W. et al . The diagnostic and therapeutic utility of thoracoscopy: a review.  Chest. 1995;  108 828-841
• 84 Loddenkemper R. Thoracoscopy - state of the art.  Eur Respir J. 1998;  11 213-221
• 85 Boutin C, Viallat J R, Cargnino P. Thoracoscopy in malignant pleural effusions.  Am Rev Respir Dis. 1981;  124 588-592
• 86 Oldenburg Jr F A, Newhouse M T. Thoracoscopy: a safe accurate diagnostic procedure using the rigid thoracoscope and local anesthesia.  Chest. 1979;  75 45-50
• 87 Menzies R, Charbonneau M. Thoracoscopy for the diagnosis of pleural disease.  Ann Intern Med. 1991;  114 271-276
• 88 Canto A, Blasco E, Casillas M. et al . Thoracoscopy in the diagnosis of pleural effusions.  Thorax. 1977;  32 550-554
• 89 Boutin C, Viallat F R, Aelony Y. Practical thoracoscopy. Berlin: Springer-Verlag 1991
• 90 Brandt J H, Loddenkemper R, Mai J. Atlas der diagnostischen Thorakoskopie. Indikationen - Technik. Stuttgart - New York: Thieme 1983
• 91 Weissberg D, Kaufmann M, Schwecher I. Pleuroscopy in clinical evaluation and staging of lung cancer.  Poumon Coeur. 1981;  37 241-143
• 92 Canto A, Ferrer G, Romagosa V. et al . Lung cancer and pleural effusion: clinical significance and study of pleural metastatic locations.  Chest. 1985;  87 649-652
• 93 Canto A, Arnau A, Galbis J. et al . The so-called malignant pleural effusion: a new review of direct data obtained with diagnostic pleuroscopy.  Arch Bronchopneumol. 1996;  32 453-458
• 94 Boutin C, Rey F. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 1: Diagnosis.  Cancer. 1993;  72 389-393
• 95 Boutin C, Rey F, Gouvernet J. et al . Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 2: Prognosis and staging.  Cancer. 1993;  72 394-404
• 96 International Mesothelioma Interest Group . A proposed new international TNM staging system for malignant pleural mesothelioma.  Chest. 1995;  108 1122-1128
• 97 Boutin C, Schlesser M, Frenay C. Malignant pleural mesothelioma.  Eur Respir J. 1998;  12 972-981
• 98 Boutin C, Dumortier P, Rey F. et al . Black spots concentrate oncogenic asbestos fibers in the parietal pleura: thoracoscopic and mineralogic study.  Am J Respir Crit Care Med. 1996;  153 111-119
• 99 Levine M N, Young J E, Ryan E D. et al . Pleural effusion in breast cancer: thoracoscopy for hormone receptor determination.  Cancer. 1986;  57 324-327
• 100 Schwarz C, Lübbert H, Rahn W. et al . Medical thoracoscopy: hormone receptor content in pleural metastases due to breast cancer.  Eur Repir J. 2004;  24 728-720
• 101 Celikoglu F, Teirstein A S, Krellenstein D J. et al . Pleural effusion in non-Hodgkin's lymphoma.  Chest. 1992;  101 1357-1360
• 102 Loddenkemper R. Thoracoscopy: results in non-cancerous and idiopathic pleural effusions.  Poumon Coeur. 1981;  37 261-264
• 103 Martensson G, Petterson K, Thiringer G. Differentiation between malignant and nonmalignant pleural effusions.  Eur J Respir Dis. 1985;  7 326-334
• 104 Storey D D, Dines D E, Coles D T. Pleural effusion: a diagnostic dilemma.  J Am Med Assoc. 1976;  236 2183-2186
• 105 Hirsch A, Ruffie P, Nebut M. et al . Pleural effusion: laboratory tests in 300 cases.  Thorax. 1979;  34 105-112
• 106 Lamy P, Canet B, Martinet Y. et al . Evaluation des moyens diagnostiques dans les epanchements pleuraux.  Poumon Coeur. 1980;  6 83-94
• 107 Ryan C J, Rodgers R F, Uni U K. et al . The outcome of patients with pleural effusion of indeterminate cause at thoracotomy.  Mayo Clin Proc. 1981;  56 145-149
• 108 Kelly P, Fallouh M, O'Brien A. et al . Fibreoptic bronchoscopy in the management of lone pleural effusion: a negative study.  Eur Respir J. 1990;  3 397-398
• 109 Feinsilver S H, Barrows A A, Braman S S. Fiberoptic bronchoscopy and pleural effusion of unknown origin.  Chest. 1986;  90 516-519
• 110 Poe R H, Levy P C, Israel R H. et al . Use of fiberoptic bronchoscopy in the diagnosis of bronchogenic carcinoma: a study in patients with idiopathic pleural effusions.  Chest. 1994;  105 1663-1667
• 111 McKneally M F, Lewis R J. Statement of the AATS/STS Joint Committee on thoracoscopic and video-assisted thoracic surgery.  Ann Thorac Surg. 1992;  54 1
• 112 Light R W, Jenkinson S G, Minh V. et al . Observations on pleural pressures as fluid is withdrawn during thoracentesis.  Am Rev Respir Dis. 1980;  121 799-804
• 113 Lan R S, Lo S K, Chuang M L. et al . Elastance of the pleural space: a predictor for the outcome of pleurodesis in patients with malignant pleural effusion.  Ann Intern Med. 1997;  16 768-774
• 114 Krell W S, Rodarte J R. Effects of acute pleural effusion on respiratory system mechanics in dogs.  J Appl Physiol. 1985;  59 1458-1463
• 115 Light R W, Stansbury D W, Brown S E. The relationship between pleural pressures and changes in pulmonary function after therapeutic thoracentesis.  Am Rev Respir Dis. 1986;  133 658-661
• 116 Perpina M, Benlloch E, Marco V. et al . Effect of thoracentesis on pulmonary gas exchange.  Thorax. 1983;  38 747-750
• 117 Karetzky M S, Kothari G A, Fouree J A. Effect of thoracentesis on arterial oxygen tension.  Respiration. 1978;  36 96-103
• 118 Brandstetter R D, Cohen R P. Hypoxaemia after thoracentesis: a predictable and treatable condition.  JAMA. 1979;  242 1060-1061
• 119 Brown N E, Zamle N, Aberman A. Changes in pulmonary mechanics and gas exchange following thoracentesis.  Chest. 1978;  74 540-542
• 120 Sprung C L, Loewenherz J W, Baier H. et al . Evidence for increased permeability in re-expansion pulmonary oedema.  Am J Med. 1981;  71 497-500
• 121 Lee Y CG, Baumann M H, Maskell N A. et al . Pleurodesis practice for malignant pleural effusions in five English-speaking countries.  Chest. 2003;  124 2229-2238
• 122 Villanueva A G, Gray Jr A W, Shahian D M. et al . Efficacy of short term versus long term tube thoracostomy drainage before tetracycline pleurodesis in the treatment of malignant pleural effusions.  Thorax. 1994;  49 23-25
• 123 Walker-Renard P, Vaughan L M, Sahn S A. Chemical pleurodesis for malignant pleural effusions.  Ann Intern Med. 1994;  120 56-64
• 124 Hamed H, Fentiman I S, Chaudary M A. et al . Comparison of intracavitary bleomycin and talc for the control of pleural effusions secondary to carcinoma of the breast.  Br J Surg. 1989;  76 1266-1267
• 125 Hartman D L, Gaither J M, Kesler K A. et al . Comparison of insufflated talc under thoracoscopic guidance with standard tetracycline and bleomycin pleurodesis for control of malignant pleural effusions.  J Thorac Cardiovasc Surg. 1993;  10 743-748
• 126 Fentiman I S, Rubens R D, Hayward J L. A comparison of intracavitary talc and tetracycline for the control of pleural effusions secondary to breast cancer.  Eur J Cancer Clin Oncol. 1986;  22 1079-1081
• 127 Kennedy L, Rusch V W, Strange C. et al . Pleurodesis using talc slurry.  Chest. 1994;  106 342-346
• 128 Patz E F, McAdams H P, Erasmus J J. et al . Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs. doxycycline with small-bore catheter drainage.  Chest. 1998;  113 1305-1311
• 129 Goff B A, Mueller P R, Muntz H G. et al . Small chest-tube drainage followed by bleomycin sclerosis for malignant pleural effusions.  Obstet Gynecol. 1993;  81 993-996
• 130 Parker L A, Charnock G C, Delany D J. Small bore catheter drainage and sclerotherapy for malignant pleural effusions.  Cancer. 1989;  64 1218-1221
• 131 Thompson R L, Yau J C, Donnelly R F. et al . Pleurodesis with iodized talc for malignant effusions using pigtail catheters.  Ann Pharmacother. 1998;  32 739-742
• 132 Marom E M, Patz Jr E F, Erasmus J J. et al . Malignant pleural effusions: treatment with small-bore catheter, thoracostomy and talc pleurodesis.  Radiology. 1999;  210 277-281
• 133 Bloom A I, Wilson M W, Kerlan Jr R K. et al . Talc pleurodesis through small-bore percutaneous tube.  Cardiovasc Intervent Radio. 1999;  24 433-438
• 134 Heffner J E, Sanderfer R J, Torstveit J. et al . Clinical efficacy of doxycycline for pleurodesis.  Chest. 1994;  105 1743-1747
• 135 Pulsiripunya C, Youngchaiyud P, Pushpakom R. et al . The efficacy of doxycycline as a pleural sclerosing agent in malignant pleural effusion: a prospective study.  Respirology. 1996;  1 69-72
• 136 Moffett M J, Ruckdeschel J C. Bleomycin and tetracycline in malignant pleural effusions. a review.  Semin Oncol. 1992;  19 (Suppl. 5) 59-63
• 137 Martinez-Moragon E, Aparicio J, Rogado M C. et al . Pleurodesis in malignant pleural effusions: a randomized study of tetracycline versus bleomycin.  Eur Respir J. 1997;  10 2380-2383
• 138 Zimmer P W, Hill M, Casey K. et al . Prospective randomized trial of talc slurry vs. bleomycin in pleurodesis for symptomatic malignant pleural effusions.  Chest. 1997;  112 430-434
• 139 Diacon A H, Wyser C, Bolliger C. et al . Prospective randomized comparison of thoracoscopic talc poudrage under local anesthesia versus bleomycin instillation for pleurodesis in malignant pleural effusions.  Am J Respir Crit Care Med. 2000;  162 1445-1449
• 140 Windsor P G, Como J A, Windsor K S. Sclerotherapy for malignant pleural effusions: alternatives to tetracycline.  South Med J. 1994;  87 709-714
• 141 United States Pharmacopeia .United States Pharmacopeia XXII, 22nd ed. Rockville: MD 1990: 1309-1310
• 142 Kennedy L, Vaughan L M, Steed L L. et al . Sterilization of talc for pleurodesis: available techniques, efficacy, and cost analysis.  Chest. 1995;  107 1032-1034
• 143 Mattison L ME, Sahn S A. More on talc sterilization.  Chest. 1996;  109 1667-1668
• 144 Montes J F, Ferrer J, Villarino M A. et al . Influence of talc dose on extrapleural talc dissemination after talc pleurodesis.  Am J Respir Crit Care Med. 2003;  168 348-355
• 145 Ferrer J, Montes J F, Villarino M A. et al . Influence of particle size on extrapleural talc dissemination after talc slurry pleurodesis.  Chest. 2002;  122 1018-1027
• 146 Rinaldo J E, Owens G R, Roger R M. Adult respiratory distress syndrome following intrapleural instillation of talc.  J Thorac Cardiovasc Surg. 1983;  85 523-526
• 147 Todd T RJ, Delarue N C, Ilves R. et al . Talc poudrage for malignant pleural effusion.  Chest. 1980;  78 542-543
• 148 Fentiman I S, Rubens R D, Hayward J L. Control of pleural effusions in patients with breast cancer.  Cancer. 1983;  52 737-739
• 149 Yin A C, Chan A T, Lee T W. et al . Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion.  Ann Thorac Surg. 1996;  62 1655-1658
• 150 Weissberg D, Ben-Zeev I. Talc pleurodesis: experience with 360 patients.  J Thorac Cardiovasc Surg. 1993;  106 689-695
• 151 Viallat J R, Rey F, Astoul P. et al . Thoracoscopic talc poudrage pleurodesis for malignant effusions: a review of 360 cases.  Chest. 1996;  110 1387-1393
• 152 Kennedy L, Sahn S A. Talc pleurodesis for the treatment of pneumothorax and pleural effusions.  Chest. 1994;  106 1215-1222
• 153 Lange P, Mortensen J, Groth S. Lung function 22 - 25 years after treatment of idiopathic spontaneous pneumothorax with talc poudrage or simple drainage.  Thorax. 1988;  43 559-561
• 154 Knowles J H, Storey C F. Effects of pleural talc poudrage on pulmonary function.  J Thorac Surg. 1957;  34 250-256
• 155 Paul J S, Beattie E J, Blades B. Lung function studies in poudrage treatment of recurrent spontaneous pneumothorax.  J Thorac Surg. 1951;  22 52-61
• 156 Kleinfeld M, Messite J, Kooyman O. et al . Mortality among talc miners and millers in New York State.  Arch Environ Health. 1967;  14 663-667
• 157 Chappell A G, Johnson A, Charles W J. et al . A survey of the long-term effects of talc and kaolin pleurodesis.  Br J Dis Chest. 1979;  73 285-288
• 158 Rodriguez-Panadero F. Talc pleurodesis for treating malignant pleural effusions.  Chest. 1985;  108 1178-1179
• 159 Sanchez-Armengol A, Rodriguez-Panadero F. Survival and talc pleurodesis in metastatic pleural carcinoma, revisited: report of 125 cases.  Chest. 1993;  104 1482-1485
• 160 Sahn S A. Pleural malignancies in pulmonary and critical care medicine. In: Bone RC, Dantzker DR, George RB, Matthay RA, Reynolds HB (eds). Pulmonary and Critical Care Medicine. 5th ed. St. Louis, MO: CV Mosby 1997
• 161 Mager H J, Maesen B, Verzijbergen F. et al . Distribution of talc suspension during treatment of malignant pleural effusions with talc pleurodesis.  Lung Cancer. 2002;  36 77-81
• 162 Dryzer S, Allen M L, Strange C. et al . A comparison of rotation and non-rotation in tetracycline pleurodesis.  Chest. 1993;  104 1763-1766
• 163 Petrou M, Kaplan D, Goldstraw P. The management of recurrent malignant pleural effusions: the complementary role of talc pleurodesis and pleuroperitoneal shunting.  Cancer. 1995;  75 801-805
• 164 Pien G W, Gant M J, Washam C L. et al . Use of an implantable pleural catheter for trapped lung syndrome in patients with malignant pleural effusion.  Chest. 2001;  119 1641-1646
• 165 Fry W A, Khandekar J D. Parietal pleurectomy for malignant pleural effusion.  Ann Surg Oncol. 1995;  2 160-164
• 166 Al-Kattan K M, Kaplan D K, Goldstraw P. The non-functioning pleuroperitoneal shunt: revise or replace?.  Thorac Cardiovasc Surg. 1994;  42 310-312
• 167 Figlin R, Mendoza E, Piantadosi S. et al . Intrapleural chemotherapy without pleurodesis for malignant pleural effusions. LCSG trial 861.  Chest. 1994;  106 363S-366S
• 168 Masuno T, Kishimoto S, Ogura T. et al . A comparative trial of LC 9018 plus doxorubicin alone for the treatment of malignant pleural effusion secondary to lung cancer.  Cancer. 1991;  68 1495-1500
• 169 Ike O, Shimuzu V, Hitomi S. et al . Treatment of malignant pleural effusions with doxorubicin hydrochloride-containing poly(-L-lactic acid) microspheres.  Chest. 1991;  99 911-915
• 170 Rosso R, Rimoldi R, Salvati F. et al . Intrapleural natural beta interferon in the treatment of malignant pleural effusions.  Oncology. 1988;  45 253-256
• 171 Astoul P H, Viallat J R, Laurent J C. et al . Intrapleural recombinant IL-2 in passive immunotherapy for malignant pleural effusion.  Chest. 1993;  103 209-213
• 172 Viallat J R, Boutin C, Rey F. et al . Intrapleural immunotherapy with escalating doses of IL-2 in metastatic pleural effusions.  Cancer. 1993;  71 4067-4071
• 173 Boutin C, Viallat J R, Van Zandwijk N. et al . Activity of intrapleural recombinant gamma-interferon in malignant mesothelioma.  Cancer. 1991;  67 2033-2037
• 174 Boutin C, Nussbaum E, Monnet I. et al . Intrapleural treatment with gamma-interferon in early stage malignant pleural mesothelioma.  Cancer. 1994;  74 2460-2467
• 175 Monti G, Jaurand M C, Monnet I. et al . Intrapleural production of interleukin 6 during mesothelioma and its modulation by gamma-interferon treatment.  Cancer. 1994;  54 4419-4423
• 176 Hartmann C A, Schutze H. Mesothelioma-like tumours of the pleura: a review of 72 autopsy cases.  Cancer Res Clin Oncol. 1994;  120 331-347
• 177 Le Roux B T. Bronchial Carcinoma. Edinburgh: E & S Livingstone 1968: 127-130
• 178 Decker D A, Dines D E, Payne W S. et al . The significance of cytologically negative pleural effusion in bronchogenic carcinoma.  Chest. 1978;  74 640-642
• 179 Livingston R B, McCracken J D, Trauth C J. et al . Isolated pleural effusion in small cell lung carcinoma: favorable prognosis.  Chest. 1982;  81 208-210
• 180 Rodriguez-Panadero F. Lung cancer and ipsilateral pleural effusion.  Ann Oncol. 1995;  6 1982 (Suppl. 3) S25-S27
• 181 Weissberg D, Kaufman M, Schwocher I. Pleuroscopy in clinical evaluation and staging of lung cancer.  Poumon Coeur. 1981;  37 241-243
• 182 Antman K H, Pass H I, Li F P. et al .Benign and malignant mesothelioma. In: Devita Jr. VT, Hellman S, Rosenberg SA (eds). Cancer: principles and practice of oncology, 4th ed. Philadelphia: JB Lippincott 1993: 1489-1508
• 183 Antman K H. Natural history and epidemiology of malignant mesothelioma.  Chest. 1993;  103 373S-376S
• 184 Umsawasdi T, Dhingra H M, Charnsangavej C. et al . A case report of malignant pleural mesothelioma with long-term disease control after chemotherapy.  Cancer. 1991;  67 48-54
• 185 Serke M, Loddenkemper R. Therapeutische Optionen beim diffusen malignen Pleuramesotheliom.  Pneumologie. 2005;  59 im Druck
• 186 Raju R N, Kardinal C G. Pleural effusions in breast carcinoma: analysis of 122 cases.  Cancer. 1981;  48 2524-2527
• 187 Dines D E, Pierre R V, Franzen S J. The value of cells in the pleural fluid in the differential diagnosis.  Mayo Clin Proc. 1975;  50 571-572
• 188 Bachmann A L, Macken K. Pleural effusions following supervoltage radiation for breast carcinoma.  Radiology. 1959;  2 699-702
• 189 Lees A W, Hoy W. Management of pleural effusions in breast cancer.  Chest. 1979;  75 51-53
• 190 Poe R H, Qazi R, Israel R H. et al . Survival of patients with pleural involvement by breast carcinoma.  Am J Clin Oncol. 1983;  6 523-527
• 191 Martin J J. The Nisbet Symposium: Hodgkin's disease. Radiological aspects of the disease.  Australas Radiol. 1967;  11 206-218
• 192 Hughes J C, Votaw M L. Pleural effusion in multiple myeloma.  Cancer. 1979;  44 1150-1154
• 193 Wong F M, Grace W J, Rottino A. Pleural effusions, ascites, pericardial effusions and edema in Hodgkin's disease.  Am J Med Sci. 1963;  246 678-682
• 194 Whitcomb M E, Schwan M I, Keller A R. et al . Hodgkin's disease of the lung.  Am Rev Respir Dis. 1972;  106 79-85
• 195 Jenkins P F, Ward M J, Davies P. et al . Non-Hodgkin's lymphoma, chronic lymphatic leukaemia, and the lung.  Br J Dis Chest. 1981;  75 22-30
• 196 Xaubet A, Diumenjo M C, Masin A. et al . Characteristics and prognostic value of pleural effusions in non-Hodgkin's lymphomas.  Eur J Respir Dis. 1985;  6 135-140
• 197 Bruneau R, Rubin P. The management of pleural effusions and chylothorax in lymphoma.  Radiology. 1965;  85 1085-1092
• 198 Melamed M R. The cytological presentation of malignant lymphomas and related diseases in effusions.  Cancer. 1963;  16 413-431
• 199 Dewald G, Dines D E, Weiland L H. et al . Usefulness of chromosome examination in the diagnosis of malignant pleural effusions.  N Engl J Med. 1976;  295 1494-1500
• 200 Whitcomb M E, Schwarz M I. Pleural effusion complicating intensive mediastinal radiation therapy.  Am Rev Respir Dis. 1971;  103 100-107
• 201 Van Renterghem D, Hamers J, De Schryver A. et al . Chylothorax after mantle field irradiation for Hogkin's disease.  Respiration. 1985;  48 188-189
• 202 Mares D C, Mathur P N. Medical thoracoscopic talc pleurodesis for chylothorax due to lymphoma: a case series.  Chest. 1998;  114 731-735
• 203 Murphy M C, Newman B M, Rodgers B M. Pleuroperitoneal shunts in the management of persistent chylothorax.  Ann Thorac Surg. 1989;  48 195-200
• 204 Safa A M, Van Ordstrand H S. Pleural effusion due to multiple myeloma.  Chest. 1973;  64 246-248
• 205 Rodriguez J N, Pereira A, Martinez J C. et al . Pleural effusion in muliple myeloma.  Chest. 1991;  105 622-624
• 206 Brambilla C, Brambilla E, Carpentier F. et al . Pleural immunocytoma with Waldenström's macroglobulinemia.  Respiration. 1981;  41 139-144
• 207 Antony V B, Nasreen N, Mohammed K A. et al . Talc pleurodesis: Basic fibroblast growth factor (bFGF) mediates pleural fibrosis.  Chest. 2004;  126 1522-1528
• 208 Sterman D H, Treat J, Litzky L A. et al . Adenovirus-mediated herpes simplex virus thymidine kinase/ganciclovir gene therapy in patients with localized malignancy: results of a phase I clinical trial in malignant mesothelioma.  Hum Gene Ther. 1998;  9 1083-1092
• 209 Treat J, Kaiser L, Sterman D H. et al . Clinical protocol. Treatment of advanced mesothelioma with the recombinant adenovirus H5.010RSVTK: a phase I trial (BB-IND 6274).  Hum Gene Ther. 1996;  7 2047-2057
• 210 Shetty S, Kumar A, Johnson A. et al . Urokinase receptor in human malignant mesothelioma cells: role in tumour cell mitogenesis and proteolysis.  Am J Physiol. 1995;  12 L972-L982
• 211 Idell S, Pueblitz S, Emri S. et al . Regulation of fibrin deposition by malignant mesothelioma.  Am J Pathol. 1995;  147 1318-1329
• 212 Shetty S, Idell S. A urokinase receptor mRNA binding protein mRNA interaction regulates receptor expression and function in human pleural mesothelioma cells.  Arch Biochem Biophys. 1998;  356 265-279
• 213 Shetty S, Idell S. Post-transcriptional regulation of urokinase receptor gene expression in human lung carcinoma and malignant mesothelioma cells in vitro.  Mol Cell Biochem. 1999;  199 189-200

Bereits publizierte Beiträge zu dieser Serie:

• 108 Bildgebende Diagnostik bei Pleuraerkrankungen.  Pneumologie. 2004;  58 238-254
• 709 Pleura: Pathologie nicht-neoplastischer Erkrankungen.  Pneumologie. 2004;  58 516-524
• 110 Pleuramesotheliom - Pathologie und Pathogenese.  Pneumologie. 2004;  58 670-679
• 111 Diagnostisches Vorgehen beim Pleuraerguss.  Pneumologie. 2004;  58 777-790