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BMC Pulm Med 2021 May 10;21(1):156. Epub 2021 May 10.

Department of Respiratory Disease, Daping Hospital, Army Medical University, Chongqing, 400042, China.

Background: Capillary hemangioma can be found in many organs, but rarely in pleura. Previously, only localized pleural capillary hemangioma cases have been reported. Corticosteroids are the most commonly recommended drugs in capillary hemangioma. Read More

Anticancer Res 2021 May;41(5):2217-2225

Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.

Background/aim: Although surgical thoracoscopy is recommended in the diagnosis of malignant pleural mesothelioma (MPM), the invasiveness of this procedure is of strong concern. Our review aimed to evaluate the accuracies of medical thoracoscopy (MT), computed tomography (CT)-guided biopsy, and ultrasound (US)-guided biopsy in the diagnosis of MPM among patients with pleural effusion.

Materials And Methods: We searched the MEDLINE, Embase, Central, and International Clinical Trials Registry Platform databases for studies evaluating the diagnostic accuracy of at least one of the biopsy procedures among patients with pleural effusion of unknown aetiology who had undergone thoracentesis and/or blind biopsy. Read More

J Int Med Res 2021 May;49(5):3000605211010073

Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Fibrosing mediastinitis (FM) is a progressive, life-threatening disease characterized by extrinsic compression of mediastinal bronchovascular structures, and the clinical manifestations largely depend upon the affected structures. Pleural effusion is rarely reported in patients with FM. We herein describe a 70-year-old man who presented with recurrent breathlessness and refractory left pleural effusion. Read More

Ugeskr Laeger 2021 Apr;183(17)

Malignant pleural effusion (MPE) is a common condition, often associated with a high level of symptoms. In this review, several palliative treatments for symptomatic MPE are summarised, including repeated thoracentesis, pleurodesis and insertion of indwelling pleural catheters. Choice of treatment depends on patient symptoms, life expectancy, pleural fluid production, expected effect of oncological treatment, whether trapped lung is suspected or not, and patient preferences. Read More

Int J Health Care Qual Assur 2021 Apr;ahead-of-print(ahead-of-print)

Respiratory Division, Department of Medicine, McGill University Health Centre, Montreal, Canada.

Purpose: Small-bore drains (≤ 16 Fr) are used in many centers to manage all pleural effusions. The goal of this study was to determine the proportion of avoidable chest drains and associated complications when a strategy of routine chest drain insertion is in place.

Design/methodology/approach: We retrospectively reviewed consecutive pleural procedures performed in the Radiology Department of the McGill University Health Centre over one year (August 2015-July 2016). Read More

Chest 2021 Apr 24. Epub 2021 Apr 24.

Division of Respiratory & Critical Care Medicine, Department of Medicine, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Background: Thoracentesis and tube thoracostomy are common procedures with bleeding risks, but existing guidelines may be overly conservative. We reviewed the evidence on the safety of thoracentesis and tube thoracostomy in patients with uncorrected coagulopathy.

Research Question: Is it safe to perform thoracentesis and tube thoracostomy in patients with uncorrected coagulopathy?

Study Design And Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Read More

Breast 2021 Apr 10;58:50-56. Epub 2021 Apr 10.

Department of Medical Onology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Japan. Electronic address:

Background: Visceral crisis in metastatic breast cancer (MBC) is defined as severe organ dysfunction requiring rapidly efficacious therapy. Although weekly paclitaxel plus bevacizumab (wPTX + BV) achieves a high response rate in human epidermal growth factor receptor 2 (HER2)-negative MBC, the efficacy and safety of wPTX + BV for visceral crisis is unclear.

Methods: We retrospectively investigated patients with MBC with visceral crisis who received wPTX + BV. Read More

Cureus 2021 Mar 17;13(3):e13941. Epub 2021 Mar 17.

Internal Medicine, Rutgers New Jersey Medical School, Newark, USA.

We describe a case of a 50-year-old man with alcohol cirrhosis status post transjugular intrahepatic portosystemic shunt (TIPS) who presented with dyspnea, refractory hepatic hydrothorax (HH), and no ascites who subsequently developed acute tension hydrothorax (TH). Urgent ultrasound-guided thoracentesis was performed with a significant improvement of symptoms. Further management consisted of a chest tube placement, subsequently removed with a plan for intermittent thoracentesis as needed, diuretic therapy, and salt restriction. Read More

Diagn Cytopathol 2021 Jun 15;49(6):785-789. Epub 2021 Apr 15.

Department of Pathology, Montefiore Hospital and Medical Center/Albert Einstein College of Medicine, New York, New York, USA.

We present a rare case of primary effusion lymphoma (PEL) in a 75 year old, HIV-negative male patient with multiple comorbidities. Imaging studies revealed a massive right pleural effusion and a significant lung collapse with multiple plural soft tissue nodules. Immediate thoracentesis was performed. Read More

Chest 2021 May 11. Epub 2021 May 11.

Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:

Background: Evidence-based guidelines recommend management strategies for malignant pleural effusions (MPEs) based on life expectancy. Existent risk-prediction rules do not provide precise individualized survival estimates.

Research Question: Can a newly developed continuous risk-prediction survival model for patients with MPE and known metastatic disease provide precise survival estimates?

Study Design And Methods: Single-center retrospective cohort study of patients with proven malignancy, pleural effusion, and known metastatic disease undergoing thoracentesis from 2014 through 2017. Read More

Cureus 2021 Mar 6;13(3):e13742. Epub 2021 Mar 6.

Pulmonary and Critical Care, Lewis Gale Medical Center, Salem, USA.

Limited scleroderma falls under the umbrella of systemic sclerosis, an autoimmune disease that presents with multiorgan dysfunction that includes pulmonary arterial hypertension. We examine a case of pulmonary arterial hypertension in an elderly nonsmoker with a history of limited scleroderma.  The patient presented with abdominal tenderness and was diagnosed with a sigmoid colonic stricture. Read More

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Haemorrhage in patients with haemophilia is common after minor trauma but may occur spontaneously. Despite the diversity of bleeding sites, spontaneous haemothorax, on a non-traumatic basis, is an exceedingly rare event and only a few cases had been reported. We present a case of a 43-year-old man with a history of haemophilia A who had pleuritic chest pain for 1 day without significant history of trauma. Read More

Cureus 2021 Feb 27;13(2):e13593. Epub 2021 Feb 27.

Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA.

Malignant pleural effusion (MPE) due to renal cell carcinoma (RCC) is extremely rare, accounting for only 1%-2% of all malignant pleural effusions. This paper presents a case report of a 56-year-old male who presented with a chief complaint of bilateral flank pain with dyspnea and was diagnosed with RCC via immunopathologic pleural fluid analysis and who persistently had recurrent large volume pleural effusion. A 56-year-old male who had a recent admission for dyspnea secondary to a right-sided pleural effusion underwent thoracentesis and returned to the hospital for his worsening shortness of breath. Read More

BMJ Case Rep 2021 Mar 22;14(3). Epub 2021 Mar 22.

Clinic of Neonatology, Department Woman-Mother-Child, CHUV, Lausanne, VD, Switzerland.

Two neonates were presented at the Neonatology Department of the Institute of Child Nutrition and Health in Conakry, Guinea, with tension pneumothoraces as confirmed by chest X-ray. They were initially managed with needle thoracentesis but required continuous thoracic drainage. Due to scarce resources in the public health sector, no prepacked and dedicated pleural drainage systems were available as is the case in many developing countries. Read More

BMJ Support Palliat Care 2021 Mar 22. Epub 2021 Mar 22.

Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain

Background: Advance directives (ADs) have been legally regulated to promote autonomy over health decisions among patients who later lose decision-making capacity.

Aims And Objectives: To analyse the differences in clinical practice at end of life among people who had completed an AD versus those who had not.

Methods: Retrospective case-control study (1:2), matched by age, sex, year, cause of death and region of residence. Read More

Diagn Cytopathol 2021 Mar 22. Epub 2021 Mar 22.

Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

Myeloid sarcoma (MS) is a mass-forming, extramedullary infiltration of myeloid blasts rarely presenting in cases of acute myeloid leukemia (AML). These tumoral masses rarely occur at any and multiple anatomic sites, precedent or coincident with bone marrow evidence of AML. We report a case of MS that presented as pancreatic and cardiac masses where subsequent evaluation of pleural effusion cytology rendered the diagnosis. Read More

BMC Pulm Med 2021 Mar 19;21(1):95. Epub 2021 Mar 19.

Department of Clinical Laboratory, Peking University People's Hospital, Xizhimen South Avenue No. 11, Beijing, 100044, China.

Purpose: Pleural effusion (PE) is a common clinical manifestation, and millions of people suffer from pleural disease. Herein, this retrospective study was performed to evaluate the biomarkers and ratios in serum and pleural fluid (PF) for the differential diagnosis of the multiple types of PE and search for a new diagnostic strategy for PE.

Methods: In-patients, who developed tuberculous PE (TPE), malignant PE (MPE), complicated parapneumonic effusion (CPPE), uncomplicated PPE (UPPE), or PE caused by connective tissue diseases (CTDs) and underwent thoracentesis at Peking University People's Hospital from November 2016 to April 2019, were included in this study. Read More

Medicine (Baltimore) 2021 Mar;100(11):e25162

Respiratory Disease Center.

Rationale: Levels of pleural fluid adenosine deaminase (ADA), a useful marker for the diagnosis of tuberculous pleurisy, are elevated in some reports of immunoglobulin G4 (IgG4)-related pleural effusion. We describe a patient with IgG4-related pleural effusion who exhibited a high concentration of ADA. Furthermore, we reviewed the literature to compare patients with IgG4-related pleural effusion and tuberculous pleurisy. Read More

Explore (NY) 2021 Feb 16. Epub 2021 Feb 16.

Department of Respiratory Medicine, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine (BUCM), No. 5 Haiyuncang, Dongcheng District, Beijing 100700, China. Electronic address:

The main clinical manifestations of pleural effusion are exertional dyspnea, predominantly dry cough, and pleuritic chest pain. To treat pleural effusion appropriately, it is important to determine its etiology; which however, remains unclear in nearly 20% of cases.A 73-year-old man with a history of invasive pulmonary tuberculosis (TB), had been experiencing chest congestion and dyspnea with undiagnosed pleural effusion for six years. Read More

Circ Rep 2020 Jun 2;2(7):357-363. Epub 2020 Jun 2.

Internal Medicine, Nishida Hospital Oita Japan.

There is scant clinical data of electrolyte analyses in the pleural fluid under heart failure (HF) pathophysiology. This study retrospectively analyzed data from 17 consecutive patients who presented with pleural effusion and underwent thoracentesis. A diagnosis of worsening HF was established by clinical criteria (presentation, echocardiography, serum B-type natriuretic peptide, and response to therapy). Read More

Physiol Res 2020 12;69(Suppl 4):S637-S647

Neonatal Department of Intensive Medicine Comenius University in Bratislava, National Institute of Children's Diseases, Bratislava, Slovak Republic.

Congenital lung masses (CLM) the rare group of causes of acute respiratory insufficiency (RI) in newborns include congenital airway pulmonary malformation (CAPM), congenital overinflation, bronchopulmonary sequestration, and bronchial atresia. The presenting group consists of 13 newborns who were admitted to the Neonatal Department of Intensive Medicine (NDIM) during January 1st 2015-December 31st 2019 (8 males, 5 females, 2 premature/11 term newborns, spontaneous delivery: 2, caesarean section: 11) with positive prenatal diagnosis of CAPM in all cases. In 2 cases prenatal intervention was performed (drainage of the amniotic fluid, attempt of thoracentesis). Read More

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:2324709621997245

Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, NY, USA.

A 41-year-old female with a past medical history significant only for right retinal vein occlusion presented with chest pain, cough, and shortness of breath. After being found to have a large right-sided pleural effusion and undergoing a nondiagnostic thoracentesis, a noncontrast chest computed tomography scan revealed multiple diffuse nodules in the right lung with irregular paraspinal pleural thickening. An extensive workup followed, with computed tomography-guided biopsy ultimately revealing the diagnosis. Read More

Surg Case Rep 2021 Feb 23;7(1):56. Epub 2021 Feb 23.

Department of General Thoracic Surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.

Background: Bilateral empyema is rare and can be life-threatening. Few cases have ever been reported about bilateral empyema with fistula on both sides. We herein report a case of bilateral empyema with bilateral fistulae that was treated with a 2-stage operation. Read More

Hosp Pract (1995) 2021 Mar 1:1-7. Epub 2021 Mar 1.

Departments of Internal Medicine and Pediatrics, University of North Carolina School of Medicine, Chapel Hill, United States.

: Procedural complications are a common source of adverse events in hospitals, especially where bedside procedures are often performed by trainees. Medical procedure services (MPS) have been established to improve procedural education, ensure patient safety, and provide additional revenue for services that are typically referred. Prior descriptions of MPS have reported outcomes over one to 2 years. Read More

Clin Pract 2021 Jan 29;11(1):32-36. Epub 2021 Jan 29.

Hematology Department, Centro Hospitalar do Baixo Vouga, Artur Ravara, 3810-164 Aveiro, Portugal.

Pleural involvement in Non-Hodgkin Lymphoma (NHL) is well documented, but primary pleural lymphomas are extremely rare, occurring mostly in immunosuppressed patients or associated with chronic pleural inflammation. Nevertheless, the pathogenesis and therapeutic approaches to counteract primary pleural lymphomas are still matter of debate. The authors present the clinical case of an 81-year-old female with respiratory and constitutional symptoms. Read More

Hepatol Commun 2021 Feb 12;5(2):272-282. Epub 2020 Dec 12.

Digestive Disease Section Internal Medicine Yale School of Medicine New Haven CT USA.

In patients with decompensated cirrhosis, procedure-related bleeding is a potentially lethal complication. Routine coagulation tests such as international normalized ratio and platelet count do not predict bleeding risk. We investigated whether thromboelastography (TEG) can identify patients with cirrhosis who are at risk of procedure-related bleeding. Read More

Sr Care Pharm 2021 Feb;36(2):97-103

To describe the case of an 88-yearold male with rheumatoid arthritis who developed pulmonary manifestations. Treatment for his RA previously included various biologics, while at the time of pulmonary consultation included meloxicam, methotrexate, and abatacept. Following chest scans, bronchoscopy, needle biopsy, pulmonary function testing, and a thoracentesis, the diagnosis of pleural effusion and nodules associated with rheumatoid arthritis was determined. Read More