Name of the Condition

• Malignant Pleural Effusion (J91.0)
• Also referred to as cancer-related pleural effusion.

Summary

Malignant pleural effusion is the accumulation of fluid in the pleural space around the lungs due to cancer. This condition often results from cancer spreading to the pleura, the thin layers covering the lungs and chest wall.

Causes

• The primary cause is the spread of cancer to the pleural space.
• Commonly associated cancers include lung cancer, breast cancer, and lymphomas.
• Tumor cells can increase the permeability of blood vessels, causing fluid to leak into the pleural space.

Risk Factors

• Having a history of cancer, particularly those known to metastasize to the pleura.
• Advanced age, as cancer is more common in older adults.
• Smoking, which is a risk factor for developing certain types of cancer.

Symptoms

• Shortness of breath (dyspnea)
• Chest pain or discomfort
• Persistent cough
• General fatigue or malaise

Diagnosis

• Chest X-ray or CT scan to visualize fluid accumulation.
• Thoracentesis, where fluid is extracted from the pleural space for analysis.
• Pleural biopsy in certain cases to determine the presence of cancer cells.

Treatment Options

• Thoracentesis to relieve symptoms by removing excess fluid.
• Chemical pleurodesis to prevent fluid reaccumulation.
• Chemotherapy or targeted therapy, depending on the type of underlying cancer.
• Palliative care to manage symptoms and improve quality of life.

Prognosis and Follow-Up

• Prognosis largely depends on the underlying cancer and its response to treatment.
• Regular follow-up is essential to monitor fluid levels and manage symptoms.

Complications

• Respiratory distress if fluid accumulation is significant.
• Risk of infection or pneumonia.
• Diminished quality of life due to symptoms like breathlessness and discomfort.

Lifestyle & Prevention

• No specific lifestyle changes can prevent malignant pleural effusion.
• Managing and monitoring underlying cancer is crucial.
• Avoid smoking to reduce the risk of cancer-related complications.

When to Seek Professional Help

• Worsening shortness of breath or chest pain.
• Development of new or persistent cough.
• Any signs of respiratory distress or infection.

Additional Resources

• American Cancer Society (www.cancer.org)
• National Cancer Institute (www.cancer.gov)
• Lung Cancer Foundation of America (www.lcfamerica.org)

Tips for Medical Coders

• Ensure correct ICD-10 coding by confirming the diagnosis as malignant pleural effusion (J91.0).
• Double-check for associated codes related to the underlying cancer type.
• Avoid confusion with non-malignant pleural effusion codes.