PMC5588660_01
Cross sectional chest imaging. a CT scan of the chest showing bilateral pulmonary metastatic nodules, new onset of moderate bilateral pleural effusion but no evidence of significant pericardial effusion 5 days after administration of nivolumab. b Coronary angiography via left heart catheterization showing unchanged left main coronary artery, eccentric stenosis in the proximal LAD and patent stents in mid LAD and ramus intermedius. There was patency of the stents in the proximal-mid segments of LAD and ramus intermedius arteries but 70% stenosis in the distal right posterior descending artery consistent with findings on the most recent routine coronary angiography performed approximately 3 weeks prior to presentation
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F1
Five days after the administration of the first dose of nivolumab, the patient experienced progressively increasing dyspnea on exertion, decreased urine output, and generalized swelling and required therapeutic thoracentesis to drain approximately 1200 ml of pleural fluid (Fig. 1a). Coronary angiography showed no new stenosis in comparison with a recent surveillance angiography 3 weeks previously (Fig. 1b).