What are the common causes of pleural disease that I should consider in a patient with a history of lung cancer?

In a patient with a history of lung cancer, common causes of pleural disease to consider include malignant pleural involvement from lung cancer itself and mesothelioma, especially if there is a history of asbestos exposure. Pleural disease signs in such patients warrant urgent chest X-ray investigation to assess for pleural malignancy or recurrence. Other causes such as infection or non-malignant pleural effusions should also be considered but malignancy remains a primary concern in this context.

Key causes:

• Malignant pleural effusion due to lung cancer metastasis or local invasion.
• Mesothelioma, particularly in patients with asbestos exposure.
• Other pleural diseases such as infection or inflammatory causes, though less common in this context.

Urgent chest X-ray is recommended for patients over 40 with pleural signs and a history of smoking or asbestos exposure to promptly identify pleural malignancy or recurrence of lung cancer ¹.