• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.1
• /
• pp.81-86
• /
• 2005

Massive pancreatic pleural effusion is a rare complication of chronic pancreatitis. It results from leakage of pancreatic secretion into the pleural space through the aortic or esophageal hiatus, either by a pancreatic duct disruption or communicating pseudocyst. The presentation of the pancreatic pleural effusion is often misleading as respiratory rather than abdominal symptoms because of predominance of pulmonary complaints. Markedly elevated amylase level of the pleural fluid is highly suggestive of the diagnosis. We experienced a case of chronic pancreatitis with massive pleural effusion in a 9-year-old female, who presented with a 6-months history of intermittent abdominal pain, and cough and chest pain for 3 days.

• Tuberculosis and Respiratory Diseases
• /
• v.57 no.3
• /
• pp.289-291
• /
• 2004

Malignant melanoma develops from melanocytes and frequently metastases to other organs. Common metastatic sites are other skin, lymph nodes, lung, liver, brain and bone in decreasing order of frequency. Malignant pleural effusion is less frequent manifestation of thoracic metastasis. We experienced a 57-year-old man with pleural effusion who received radical resection with local flap on left foot due to acral lentiginous melanoma 3 years ago. He had progressive chest pain and left massive pleural effusion. The pleural cytology and biopsy showed malignant melanoma. After closed thoracostomy and talc pleurodesis, he refused further immunotherapy and chemotherapy and discharged.

• The Korean Journal of Cytopathology
• /
• v.3 no.2
• /
• pp.90-93
• /
• 1992

A case of multiple myeloma with massive pleural effusion is reported. A 53 year-old previous known multiple myeloma patient vistited our hospital complaining of cough with sputum. Radiologic study revealed multiple osteolytic bony lesions and left side pleural effusion. The effusion were bloody exudates containing numerous atypical plasma cells. The tumor cells showed pleomorphism, eccentric nuclei, prominent nucleoli, perinuclear halo, multincleation, and chromatin patterns of occasional cart-wheel appearance. The cytological examination of pleural fluid established the malignant nature of the effusion with multiple myeloma.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.3
• /
• pp.684-691
• /
• 1997

1be ovarian hyperstimulation syndrome is a rare but serious complication of ovulation induction therapy with gonadotropin. The clinical manifestations are generalized edema, ascites with pleural effusion and may become life-threatening in severe cases. The pathophysiology is still unknown, therefore, the treatment should be symptomatic and conservative. We report a case of severe OHSS with massive right pleural effusion in excess of ten liters after human menopausal gonadotropin therapy because of secondary infertility. Fluid and electrolyte imbalances were corrected and albumin was administered. A right chest tube was placed for a total of sixteen days, draining eleven liters of pleural effusion totally, resulting a dramatic decrease of pleural effusion and improvement of symptoms.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.1
• /
• pp.153-156
• /
• 1994

Massive hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD) is relatively rare. A 67-year-old male and a 23-year-old female patients during CAPD presented massive pleural effusion. They have been performing peritoneal dialysis due to end-stage renal disease for 8 months and 2 weeks respectively. We injected $^{99m}Tc$-labelled radiopharmaceutiral (phytate and MAA, respectively) into peritoneal cavity with the dialysate. The anterior, posterior and right lateral images were obtained. The studies reveal visible radioactivity in the right chest indicating the communication between the peritoneal and the pleural space. After sclerotherapy with tetracycline, the same studies reveal no radioactivity in the right chest suggesting successful therapy. We think nuclear imaging is a simple and noninvasive method for the differential diagnosis of pleural effusion in patients during CAPD and the evaluation of therapy.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.5
• /
• pp.456-462
• /
• 2006

Background: Differential diagnosis is very important in patients with pleural effusions. A few studies on the etiologies of massive pleural effusions have been reported, but these were conducted in different decades and locations. In the present study, the etiologic spectrum of massive pleural effusions in Korea, were evaluated through an investigation at one university hospital. Methods: Retrospective chart reviews were performed in patients having undergone thoracentesis between July 2002 and July 2005. Pleural effusions were deemed to be massive if they occurred in two thirds or more of one hemithorax. The etiologies of massive pleural effusions, pleural fluid findings, serum laboratory findings, and sputum and pleural fluid cytologies were compared. Results: Of 298 pleural effusions cases, 41 (13.8%) had massive pleural effusions. The most frequent causes of massive pleural effusions were malignancy (19; 46.3%) followed by tuberculosis (15; 36.6%), parapneumonic effusion (4; 9.8%) and transudate (3; 7.3%). Compared with massive benign effusions, patients with massive malignant pleural effusions were more likely to have lower adenosine deaminase (ADA) activity, a higher amylase level and higher RBC count in their pleural fluids. Also, compared with non-tuberculosis effusions, patients with massive tuberculous pleural effusions were more likely to have lower RBC and neutrophil counts, but a higher lymphocyte count, adenosine deaminase (ADA) activity and protein level. Conclusion: The most common etiologies of massive pleural effusions in Korea are malignancy and tuberculosis. A high ADA content favors a tuberculous condition, while bloody effusions with a relatively lower ADA content. favors malignancy. The proportion of tuberculosis in massive pleural effusions was higher than in previous reports.

• Tuberculosis and Respiratory Diseases
• /
• v.78 no.4
• /
• pp.396-400
• /
• 2015

IgG4-related disease is an immune-mediated fibro-inflammatory disease, characterized by lymphoplasmacytic infiltration composed of IgG4-positive plasma cells of various organs with elevated circulating levels of IgG4. This disease is now reported with increasing frequency and usually affects middle-aged men. Massive pleural effusion in children is an uncommon feature in IgG4-related disease. Here, we report a case of a 16-year-old male patient with extensive IgG4-related disease presenting with massive pleural effusion, mediastinal mass, and mesenteric lymphadenopathy.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.1
• /
• pp.36-41
• /
• 1994

Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously. Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about $7.3{\times}7.1{\times}6.5cm$ in size in the upper and mid-pole of the right kidney, involving renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus. Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.22 no.6
• /
• pp.601-607
• /
• 2019

Pancreaticopleural fistula (PPF) a fistulous connection between the pancreas and pleural space due to prolonged chronic pancreatitis (CP). PPF is a very rare complication which presents in 0.4% of chronic pancreatitis cases, especially among children. We report a case involving a 3-year-old boy who presented with pleural effusion caused by a PPF, a complication of hereditary pancreatitis, which was, for the first time in Korea, successfully managed with endoscopic treatment. Chest radiography and computed tomography showed massive pleural effusion. Percutaneous catheter drainage was performed. High amylase levels were observed in the pleural fluid and serum, suggesting PPF. The patient was managed with bowel rest and octreotide infusion. Endoscopic retrograde cholangiopancreatography revealed CP, and pleural effusion was successfully managed with stent placement. PRSS1 genetic screening revealed R122H mutation.

• Tuberculosis and Respiratory Diseases
• /
• v.75 no.2
• /
• pp.71-74
• /
• 2013

Benign schwannoma is the most common neurogenic tumor in the mediastinum. Mediastinal benign schwannomas are most often asymptomatic and rarely accompanied by bloody pleural effusion. In the clinical analysis of 7 cases of pulmonary schwannomas, pleural effusion, and blood invasion were evident in 3 patients with malignant schwannoma. Herein, we report a rare case of giant, benign schwannoma presented with total collapse of right lung by massive, bloody pleural effusion.