A cloudy pleural effusion
- 1Department of Respiratory Medicine, St James' University Hospital, Leeds, UK
- 2Department of Histopathology, St James' University Hospital, Leeds, UK
- Correspondence to Dr Puneet Malhotra, Department of Respiratory Medicine, St James' University Hospital, LS9 7TF Leeds, UK;
Contributors PM suspected the diagnosis, took photographs of the pleural fluid and wrote the manuscript. JPW reviewed the manuscript and treated the patient. PKP suspected the diagnosis, referred the patient for VATS and reviewed the manuscript. RB provided the cytology images and reviewed the manuscript.
A 55-year-old previously fit and well woman was admitted with a 4-week history of dry cough and 1-week history of progressive breathlessness. She had never smoked, was on no regular medications and there was no history of heart disease, malignancy, rheumatological disease or tuberculosis.
Physical examination revealed signs of a moderate right-sided pleural effusion but was otherwise unremarkable. Full blood count, clotting, and renal and liver function tests were normal. C reactive protein was <5 mg/l. Chest x-ray revealed a moderate right sided pleural effusion.
She underwent bedside diagnostic aspiration of 50 ml of pleural fluid …