Pleural effusions can range from pure anechoic, to fibrotic (as seen here) suggesting a subacute to chronic nature, to frank iso- or hyperechoic fluid that is pathognomic for an exudate.
here's a scan using the curvilinear transducer on an abdominal preset in the sagittal plane here we are at the level of the right diaphragm and as we scan here's where lung should normally be but we see obviously it's filled with fluid and there is a lot of fibrinous exudate in here suggestive of a complex effusion in the right hemithorax of this patient and it is moderately large here on the posterior side of the thorax we see the spine sinus continuation of the bone that is conducting the sound through this liquid medium of the portal effusion
