Unilateral chest wall edema in carcinomatous pleurisy.

21 patients with protracted unilateral pleural effusion were studied with respect to the etiology of their pleurisy. 13 presented with unilateral chest wall edema (UCE). These were classified as group A patients. 8 group B patients suffered from unilateral pleural effusion without UCE. A malignant cause of the effusion was established in 8 out of the 13 patients in group A, and in 2 patients from group B. Empyema was present in 4 additional patients, all of them belonging to group A. The diagnosis of purulent pleural effusion could be made promptly by microscopic examination of the pleural fluid. If excluding the empyema patients, the presence of UCE was significantly associated (p less than 0.025) with a malignant etiology of the pleural effusion. It seems that careful examination of the chest wall skin texture can be a simple and useful method in the initial evaluation of patients with pleurisy.