case_images: PMC5862910_01
case_images: Chest X-ray with large left malignant pleural effusion immediately after pigtail catheter placement but before fluid drainage
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case_images: PMC5862910_01_12254_2018_388_Fig1_HTML.jpg
case_images: Fig1
case_images: It was then in September 2017 that the patient presented to the hospital with dyspnea and was found to have bilateral pleural effusion on chest radiography (Fig. 1).
case_images: Chest computed tomography (CT) with intravenous contrast demonstrating malignant left pleural effusion with left lower lobe collapse and segmental atelectasis in left upper lobe
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case_images: PMC5862910_01_12254_2018_388_Fig2_HTML.jpg
case_images: Fig2
case_images: His chest computed tomography (CT) was significant for left lower lobe collapse with basilar opacities as well as patchy ground glass opacities and interlobular septal thickening (Fig. 2).
case_images: Chest X-ray post placement of left hemithorax pigtail catheter with drainage and significant decrease in large left pleural effusion
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case_images: PMC5862910_01_12254_2018_388_Fig3_HTML.jpg
case_images: Fig3
case_images: Chest X-ray imaging post drainage showed diminished left lobe opacity (Fig. 3).
case_images: A cell block preparation of pleural fluid shows a prominent plasma cell concentration by hematoxylin and eosin staining
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case_images: PMC5862910_01_12254_2018_388_Fig4_HTML.jpg
case_images: Fig4
case_images: Pleural fluid immunohistochemical stains were performed (Figs. 4, 5, 6 and 7). Figs. 4, 5, 6 and 7.
case_images: Numerous atypical plasma cells with increased mitotic activity by Diff Quik air-dried stained slide
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case_images: PMC5862910_01_12254_2018_388_Fig5_HTML.jpg
case_images: Fig5
case_images: Pleural fluid immunohistochemical stains were performed (Figs. 4, 5, 6 and 7). Figs. 4, 5, 6 and 7.
case_images: The CD138 immunostain highlights numerous clonal atypical plasma cells
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case_images: PMC5862910_01_12254_2018_388_Fig6_HTML.jpg
case_images: Fig6
case_images: Pleural fluid immunohistochemical stains were performed (Figs. 4, 5, 6 and 7). Figs. 4, 5, 6 and 7.
case_images: The kappa in situ hybridization stained slide shows that a majority of the CD138 plasma cells are positive for kappa light chains
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case_images: PMC5862910_01_12254_2018_388_Fig7_HTML.jpg
case_images: Fig7
case_images: Pleural fluid immunohistochemical stains were performed (Figs. 4, 5, 6 and 7). CD138 immunostaining demonstrated atypical plasma cells with kappa restriction (Fig. 7). Figs. 4, 5, 6 and 7.