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NSCLC with malignant pleural effusion — SCE Respiratory MCQ

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HardLung CancerNSCLC with malignant pleural effusionSCE Respiratory

A 72-year-old woman has lung adenocarcinoma with malignant pleural effusion confirmed on cytology. PET-CT shows no extrathoracic metastases. What is the most likely diagnosis?

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Correct answer: B — Stage IV NSCLC due to M1a disease

A malignant pleural effusion in NSCLC represents M1a metastatic disease and therefore stage IV, even without extrathoracic metastases. Stage I and T1a disease require absence of nodal and metastatic spread. Pleural plaques are benign asbestos markers and do not explain malignant cytology.

Reference: TNM 8th/9th Edition Lung Cancer Staging; NICE NG122