Massive pleural effusion

Case contributed by Ali Shareef Fadhil Fadhil
Diagnosis almost certain

Presentation

Increasing dyspnea, dry cough, poor appetite, fatigue and lethargy.

Patient Data

Age: 65 years
Gender: Male
x-ray

A right-sided pleural effusion with total white-out of the right hemithorax and minor mediastinal shift to the left.

Minor left-sided pleural effusion.

Case Discussion

Unilateral white-out can be due to collapse, consolidation, effusion or a combination and the position of the mediastinum is key to diagnosis 1,2. Massive pleural effusion causes contralateral shift however the degree of shift depends on the degree of accompanying pulmonary collapse 1,2.

In this case, the appearance suggests a massive right pleural effusion with collapse of the right lung.

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