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Suspected lung cancer with haemoptysis — SCE Respiratory MCQ

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HardLung CancerSuspected lung cancer with haemoptysisSCE Respiratory

A patient with metastatic lung cancer has recurrent symptomatic malignant pleural effusion. Therapeutic aspiration improves breathlessness, but imaging shows more than 25% non-expandable lung. Which definitive pleural strategy is preferred?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Offer an indwelling pleural catheter for ambulatory symptom control

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · A = shown as D

D is correct. BTS advises that people with malignant pleural effusion and radiologically significant non-expandable lung should generally receive an indwelling pleural catheter rather than talc pleurodesis, because pleural apposition is inadequate for reliable pleurodesis. Repeated aspiration may suit selected short-prognosis cases but is not the default definitive approach. Routine VATS partial pleurectomy is more invasive, while observation leaves recurrent breathlessness untreated.

Reference: https://thorax.bmj.com/content/78/Suppl_3/s1