Report on twelve patients suffering from malignant primary disease associated with pleural effusion and diaphragmatic metastasis, basically diagnosed via sonography. In no case tumour formation could be detected by x-ray film. Cytohistological evidence of diaphragmal metastasis can be found by sonographically detected pleural tumours malignant effusion must be assumed, despite negative exudate cytology. In such cases diagnostic thoracoscopy is not necessary.
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