UCLH has a comprehensive service for the assessment and treatment of patients with pleural disease.

The pleura is the covering of the lungs, and chest wall.  There are many different diseases that can affect this part of the chest.  Common problems include air between the lung and the chest wall (pneumothorax) and fluid collecting between the lung and the chest wall (pleural effusion.)  To ensure that patients get the best treatment for problems affecting their chest in this way, we work as a team to get a diagnosis as quickly as possible, and to manage the symptoms and underlying disease effectively.

Because there are many causes of pleural disease, very often a number of tests are required to make a diagnosis, and some of these tests can form part of the treatment too.  These tests range from simple x-rays and blood tests up to operations, or drainage tubes placed into the space between the lungs and the chest wall. 

Patients with pleural disease require a multi-disciplinary approach, and regular MDT meetings are held between respiratory physicians, radiologists, histopathologists, oncologists and thoracic surgeons.  This ensures a rapid assessment and development of an individual management plan for each of our patients.

We have access to, and regularly use:

  • Full range of pleural imaging: ultrasound, CT scans, PET scans
  • Pleural aspirations (therapeutic and diagnostic)
  • US and CT guided pleural biopsies
  • Drainage for pleural effusions (in-patient and daycare services)
  • VATS pleural biopsies
  • VATS pleurodesis and pleurectomy
  • Dedicated respiratory cytology and histopathology services
  • Full range of oncology services for primary and secondary pleural tumours
  • TB clinic for the treatment of tuberculous effusions

Other referral information

Relevant NHS e-Referral Service (formally Choose and Book referrals) terms
•    Conditions Treated: Patients with pleural effusions, pleural thickening, pleural infections, tumours affecting the pleura (primary and secondary), and recurrent pneumothorax.
•    Exclusions: Children
•    Suggested Investigations: chest X ray

Referral guidelines
All GP referrals via NHS e-Referrals

Please provide patient’s full demographic details, including ethnic origin & NHS Number.  Please state if interpreter is required; if so, what language is needed. Transport required for first appointments must be booked by GP. Please indicate where patients have a disability.

Lead Consultant for pleural diseases: Dr Toby Hillman

Dr Toby Hillman is a Consultant in Respiratory and General (Internal) Medicine. He trained initially at Nottingham University Medical School, and completed his higher training in London on the North East Thames Respiratory Rotation.  He has completed postgraduate qualifications in Healthcare Leadership and Management, and has a specialist interest in Pleural Disease. He worked as a Locum Consultant at the London Chest Hospital before taking up his substantive position at University College Hospital.