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Pleural disease
Multiple intrathoracic extramedullary haematopoiesis as visualised on medical thoracoscopy
  1. Jiun Hang Lee1,
  2. Larry Ellee Nyanti1,2,
  3. Nai-Chien Huan1,
  4. Hema Yamini Ramarmuty1,
  5. Kunji Kannan Sivaraman Kannan1
  1. 1 Department of Respiratory Medicine, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
  2. 2 Medical Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
  1. Correspondence to Dr Jiun Hang Lee; jiunhang{at}hotmail.com

https://doi.org/10.1136/thorax-2024-221593

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    A 38-year-old man with underlying transfusion-dependent beta-thalassemia and a history of splenectomy in August 2023 presented in December of the same year, complaining of one month of dyspnoea and orthopnoea. The chest radiograph revealed bilateral pleural effusion, with a left-sided predominance. Diagnostic and therapeutic thoracentesis demonstrated straw-coloured serous pleural fluid (pf) with an exudative biochemical profile (pf protein 53 g/L, pf lactate dehydrogenase 127 U/L), while cytology revealed scattered lymphocytes. The post-thoracentesis chest radiograph revealed a pleural-based, rounded opacity (figure 1). While CT of the thorax is a pragmatic next step of investigation in this case, due to limited access to urgent CT scans at our centre, a decision was made by the treating team to proceed with medical thoracoscopy (MT). The patient underwent MT on the left, during which multiple lobulated masses were visualised along the surface …

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    Footnotes

    • Contributors LJH: guarantor, data curation, investigation and writing the original draft. LEN: conceptualisation, investigation and writing the original draft. HNC: conceptualisation, investigation, writing the original draft, editing and supervision. HYR: writing the original draft, editing and supervision. KKSK: writing the original draft, editing and supervision. All authors reviewed and approved the final draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.