A Man With Pleural Effusion and Ascites

Li, Andrew; Poon, Limei; Khoo, Kong Soo; Seet, Ju‐Ee; Sinha, Arvind; Lee, Pyng

doi:10.1378/chest.14-2237

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Ascitic fluid may cause predominantly right-sided pleural effusions due to proximity to the diaphragm as well as intradiaphragmatic rents [7]. This has been described in conditions such as disseminated tuberculosis, advanced malignancy, and pancreatitis [8]. We present a case of new-onset bilateral pleural effusions attributed to dasatinib, with potential exacerbation of ascites.…”

Section: Introductionmentioning

confidence: 96%

Dasatinib-Induced Bilateral Pleural Effusions

Rasul¹,

Gabriel²,

Flowers³

2022

Cureus

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Fluid accumulation in the form of pleural effusions and ascites may be attributed to a single etiology. Diagnosis depends on a thorough clinical history as well as fluid analysis. We present the case of a 60-yearold man with chronic myeloid leukemia (CML) on dasatinib, recent right-sided ischemic stroke, alcoholassociated liver disease, cocaine and alcohol use disorders in early remission, and hypertension who presented with subacute-onset of bilateral pleural effusions and ascites. Pleural fluid analysis showed an exudative effusion, while ascitic fluid analysis showed a transudative collection. After an extensive workup, the bilateral effusions were attributed to dasatinib therapy, which was also suspected to play an unclear role in the worsening ascites. Although peripheral edema and pleural effusions are well-recognized and common side effects of tyrosine kinase inhibitors (TKIs), this case represents the first description of a patient presenting with bilateral TKI-induced pleural effusions as well as concomitant ascites of unclear origin.

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Section: Introductionmentioning

confidence: 96%

Dasatinib-Induced Bilateral Pleural Effusions

Rasul¹,

Gabriel²,

Flowers³

2022

Cureus

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“…Li et al 5 reported a case of mediastinal seminoma diagnosed by a cytological examination of cystic fluid, which showed loose aggregates of large polygonal cells containing large nuclei with vesicular chromatin, nucleoli, and mild amounts of cytoplasm, admixed with small lymphocytes. We previously diagnosed several seminomas with metastasis to the inguinal lymph nodes.…”

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confidence: 99%

Mixed germ cell tumors metastasis to Ascitic fluid: Report of a case with immunocytochemical findings

Wang

2022

Diagnostic Cytopathology

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A rare case of indolent B cell lymphoma with massive pleural effusion as the initial presentation

2021

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Two major type of lymphoma involve the pleura as primary neoplasms: primary effusion lymphoma (PEL) in the setting of human immunodeficiency virus (HIV) infection, and pyothorax-associated lymphomas (PAL), with a strong Epstein-Barr virus (EBV) or pyothorax association. However, indolent B cell lymphoma initially manifested as pleural effusion is an extremely rare clinical occurrence. In this study, we report a case of 52-year-old woman with no history of HIV infection or pyothorax, who only manifested long-term massive bilateral pleural effusion. This patient was characterized by lymphocytic pleural effusion, which had been misdiagnosed as tuberculous hydrothorax. A total of 75 liters of pleural effusion were drained over a two-year period. After admission to our hospital, we performed flow cytometry of pleural effusion and revealed proliferation of B lymphocytes with abnormal immune markers consistent with marginal zone B cell phenotype, although lymphocyte morphology is normal. Flow cytometry on bone marrow revealed ckappa restrictive expression on B cells further, which indicating small B cell lymphoma. The right-side pleural fluid was encapsulated after thoracoscopy and the patient's symptom were relieved. Considering the foreseeable side effects of chemotherapeutic drugs and indolent potential of the small B cell lymphoma, the patient opted not to undergo further treatment. Follow up was done 1, 3 and 6 months after discharge, the depths of bilateral pleural effusion on ultrasound stabilized around 3 cm without thoracentesis. This case is thought to be an unusual presentation because the pleural lymphoma occurred on an immunocompetent adult woman and the type was small B cell lymphoma, which were totally different from PEL or PAL. We also describe the use of flow cytometry to effectively diagnose the unexplained pleural effusion, and discuss the findings using relevant previously reported literature. Overall, our findings provide new insights to deal with unexplained pleural effusion and the value of flow cytometry in diagnosis.

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A Man With Pleural Effusion and Ascites

Cited by 3 publications

References 20 publications

Dasatinib-Induced Bilateral Pleural Effusions

Dasatinib-Induced Bilateral Pleural Effusions

Mixed germ cell tumors metastasis to Ascitic fluid: Report of a case with immunocytochemical findings

A rare case of indolent B cell lymphoma with massive pleural effusion as the initial presentation

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