A 54-year-old woman comes to the office due to worsening nonproductive cough and dyspnea for the past several months. She also reports anorexia and an unintentional weight loss of 7 kg (15.4 lb). The patient has no prior medical conditions, takes no medications, and is a lifelong nonsmoker. Physical examination shows decreased breath sounds on the left side. Chest x-ray reveals a large left-sided pleural effusion. Thoracentesis yields fluid with a large number of red blood cells and numerous atypical cells staining positive for mucin. Which of the following is the most likely primary mechanism of this patient's pleural effusion?

Question

A 54-year-old woman comes to the office due to worsening nonproductive cough and dyspnea for the past several months.  She also reports anorexia and an unintentional weight loss of 7 kg (15.4 lb).  The patient has no prior medical conditions, takes no medications, and is a lifelong nonsmoker.  Physical examination shows decreased breath sounds on the left side.  Chest x-ray reveals a large left-sided pleural effusion.  Thoracentesis yields fluid with a large number of red blood cells and numerous atypical cells staining positive for mucin.  Which of the following is the most likely primary mechanism of this patient's pleural effusion?

Quizplus · Accepted Answer

Eductional Objective: Malignant pleural effusions are usually exudative by Light criteria and can occur via several mechanisms, including an inflammation-induced increase in vascular permeability (leading to increased inflow) and blockage of pleural fluid reabsorption by parietal pleura lymphatics (leading to decreased outflow).

A 54-Year-Old Woman Comes to the Office Due to Worsening