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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. 1Department of Respiratory Medicine, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
  2. 2Medical Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
  1. Correspondence to Dr Jiun Hang Lee, Respiratory Department, Hospital Queen Elizabeth, KOTA KINABALU, SABAH, Malaysia; jiunhang{at}

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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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  • 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.