PMC3568868_01
(a) Chest X-ray at presentation showing left-side pleural effusion. (b) CT pulmonary angiography showing bilateral pleural effusion. (c) Chest X-ray at the fifth day. (d) Chest X-ray at the third month.
CRIM.MEDICINE2013-981232.001.jpg
PMC3568868_01_CRIM.MEDICINE2013-981232.001.jpg
fig1
Chest radiography revealed pleural effusion on the left lung (Figure 1(a)). CT pulmonary angiography was negative for pulmonary embolism but revealed a mild right pleural effusion as well (Figure 1(b)). A repeat chest X-ray revealed increase of the pleural effusion on the right side (Figure 1(c)), which required insertion of chest tube and removal of 1 liter of exudative fluid which also had characteristics of EPE (eosinophils = 22%), whereas stains, cultures, and cytology were all negative again. Reevaluation after 3 and 6 months showed marked improvement of the radiological and clinical findings (Figure 1(d)).