BOF:
128
A 72
year old female presented with shortness of breath and a sharp,
pleuritic chest pain localized to the left lower chest wall with
radiation to the left shoulder. No significant past medical history.
On
examination she was found to have a left sided pleural effusion and this was
confirmed on chest-ray. An ECG was normal
Pleural aspiration
White blood cell count of 125 per µL (55% polymorphonuclear
leukocytes, 45% monocytes)
Lactic acid dehydrogenase of 1,652 U/L
Total protein of 5.8 g/dL
pH
7.01
Glucose 1.2 mmol/L
Gram
stains and acid-fast stains of the pleural fluid were negative
Cytology large numbers of acute inflammatory cells without evidence
for malignancy
In
this patient
In
this patient which one of the following would you arrange to substantiate the
diagnosis?
a)
Pleural fluid rheumatoid factor
b)
Pleural fluid amylase
c)
Pleural fluid anti nuclear factor
d)
Thoracoscopy
e)
Gastrograffin swallow
