Malignant pleural effusion: is CT pulmonary angiogram needed?

We have read an interesting article from Zarogoulidis et al. (1), “Malignant pleural effusion and algorithm management”, which give us the excellent guideline for managing oncologic patient with malignant pleural effusion. In oncologic patients, malignant pleural effusion is a common cause of dyspnea, however pulmonary embolism is a frequent complication which also might present with pleural effusion. The question is “do we have to rule out pulmonary embolism in all oncologic patients who presented with shortness of breath and pleural effusion?”