Week 430: Case 4

1. Presented by Peter Illei, M.D. and prepared by Hillary Ross, M.D.

The patient is a 51-year-old non-smoker white female with progressive shortness of breath of 4 weeks duration. She was found to have a large left pleural effusion. A chest CT scan revealed entrapped left upper lobe and left lower lobe as well as a pleural effusion. A 1100 mL of pleural fluid was removed and was cytologically non-diagnostic. A repeat CT scan revealed re-expansion of the left upper lobe, but left lower lobe was still entrapped. On VATS exploration, the pleura was diffusely studded with nodules that were biopsied. A left lower lobe anterior basilar segment wedge biopsy of the left lower lobe was also performed.
Images 1, 3 and 5 are of the pleura while images 2 and 4 are of the lung.