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Home | Ultrasound Library | Pleural Effusion Case 001

Pleural Effusion Case 001

by Dr James Rippey, last update September 13, 2019

A young patient with a history of sarcoma presents with shortness of breath.

What does this clip show?

Reveal Answer
  • There is a very large left sided pleural effusion.
  • It is causing complete collapse of the lung, and flattening of the diaphragm.
  • There are irregular solid deposits on the visceral and parietal pleural surfaces.
  • The fluid contains fine echogenic debris.
  • The differential diagnosis of echogenic debris within a pleural effusion includes:
    • Pus – Empyema
    • Blood – Haemothorax
    • Chyle (lymphatic material) – Chylothorax
    • Proteinaceous debris – Exudate of other cause (e.g. malignancy)
  • Differentiating solid appearing malignant pleural deposits from blood clot or dependent debris can be difficult. History and clinical examination are invaluable in the differentiation.
  • Malignant deposits will be fixed to the pleural surfaces and one may be able to demonstrate arterial flow within them using colour Doppler.
Further explanation

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About Dr James Rippey

Emergency physician with a passion for ultrasound and educating the masses. Author of the Ultrasound library and Ultrasound Top 100. @theSonoCave | + James Rippey

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