Revision 3 for 'Malignant pleural effusion'

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Malignant pleural effusion

This is a case of a 75-year-old male who presented to our hospital with a three month history of worsening shortness of breath and reduced exercise tolerance. He described a 25kg weight loss and had a 65-pack-year history of smoking.

This gentleman underwent a pleuritic tap which confirmed malignant adenocarcinoma.

MACROSCOPIC:

  • Received 50ml of cloudy yellow fluid with clots.

MICROSCOPIC:

  • Moderate cellularity
  • Malignant cells are present in a background of leukocytes (predominantly lymphocytes), histiocytes and blood
  • Malignant cells have markedly pleomorphic, hyperchromatic nuclei and moderate amounts of cytoplasm

IMMUNOHISTOCHEMISTRY:

  • Positive: AE1/3, CEA, TTF1
  • Negative: BerEp4, calretinin, WT1, CK5/6  

Features are consistent with metastatic adenocarcinoma of pulmonary origin.

He has now been referred to medical oncologists for ongoing treatment.

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