PMC4356047_01
CXR series: (A) CXR 2 years prior to presentation and prior to olanzapine therapy, (B) CXR at presentation, (C) CXR 6 months after olanzapine withdrawal.
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This effusion was not present on CXR two years previously (Fig. 1).
Computed tomography of the thorax demonstrating a small to moderate right sided pleural effusion with unremarkable pleura, and a left lower lobe calcified granuloma.
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A differential diagnosis of tuberculous pleuritis, malignancy or drug-induced pleuritis was made and the patient underwent local anaesthetic thoracoscopy (Figs. 2-4).
Papanicolaou stained cytospin demonstrating eosinophil-rich pleural fluid (cells with bi-lobed nuclei with brown granules). An eosinophilic effusion is defined as >=10% eosinophils. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
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A differential diagnosis of tuberculous pleuritis, malignancy or drug-induced pleuritis was made and the patient underwent local anaesthetic thoracoscopy (Figs. 2-4).
Pleural biopsy taken during pleuroscopy demonstrating a chronic inflammatory cell infiltrate and eosinophils.
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A differential diagnosis of tuberculous pleuritis, malignancy or drug-induced pleuritis was made and the patient underwent local anaesthetic thoracoscopy (Figs. 2-4).