PMC7587464_01
Chest X-ray showing right-sided moderate effusion with thickening.
gr1.jpg
PMC7587464_01_gr1.jpg
fig1
C-reactive protein, ferritin, and liver enzymes along with hyponatremia (Table 1). Chest X-ray and CT scan demonstrated a moderate right-sided pleural effusion, pleural thickening, and normal lung parenchyma (Fig. 1, Fig. 2).
Medical thoracoscopy view, showing inflamed parietal pleura with few adhesions.
gr3.jpg
PMC7587464_01_gr3.jpg
fig3
At thoracoscopy visually the parietal pleura was found to be mildly inflamed with a few pleural adhesions (Fig. 3).
Microscopic view showing acute fibrinous exudate (H&E x 200).
gr4.jpg
PMC7587464_01_gr4.jpg
fig4
Histopathological examination showed acute fibrinous exudate consisting of layers of fibrin mixed with abundant neutrophils (Fig. 4).
Microscopic view revealing dense fibroblastic reaction characterized by fascicles of spindle cells mixed with fewer numbers of lymphocytes, plasma cells, and eosinophils associated with deposits of dense collagen (H&E x 200).
gr5.jpg
PMC7587464_01_gr5.jpg
fig5
Also seen were areas of dense fibrosis characterized by fascicles of spindle cells mixed with fewer numbers of lymphocytes, plasma cells as well as eosinophils associated with deposits of dense collagen (Fig. 5) with no evidence of granulomas or malignancy.