Pulmonary - Septated Pleural Effusion
Caption
76yo male with shortness of breath on exertion, w/o fever or other signs of infection. POCUS showed a large septated unilateral pleural effusion. Note the irregular and thickened pleura adjacent to the diaphragm (right). Thoracentesis was only partially successful with a large residual effusion after drainage of 1000ml of exudative fluid with signs of lymphocytic inflammation w/o malignant cells on cytopathologic analysis. Thoracoscopic biopsy confirmed the diagnosis of a pleural mesothelioma 60 years after exposure to asbestos. The presence of a septated complex effusion is 94% specific for an exudative effusion and warrants further investigation (Shkolnik, 2020). Cytopathology of pleural fluid is often negative in malignant mesothelioma and pleural biopsies are needed to confirm the diagnosis (Porcel, 2014). Victor Speidel Langenthal Regional Hospital, Switzerland