Pleural effusion as an initial manifestation in a patient with primary pulmonary monoclonal B-cell lymphocyte proliferative disease

Excerpt

Pleural effusion, the most common manifestation of pleural disorders, is an abnormal accumulation of fluid in the pleural cavity. In a developing country such as China, infections, particularly tuberculosis, are the predominant cause of pleural effusion [1]. Other causes, such as inflammation and malignancy, are also common. In this report, we describe a 65-year-old woman with massive bilateral pleural effusion and a left pulmonary nodule. The results of fine needle aspiration of the pulmonary nodule suggested fungal infection, likely caused by Cryptococcus. After the regular treatment of fluconazole for 4 months, the left pulmonary nodule disappeared, but bilateral pleural effusion persisted (Fig. 1). The results of phenotypic lymphocyte screening by flow cytometry of both blood and bilateral pleural effusion supported the diagnosis of primary pulmonary monoclonal B-cell lymphocyte proliferative disease. We further discuss the current understanding of this disease, including the possible pathogenesis.

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