case_images: PMC11787820_01
case_images: Chest radiography revealing bilateral pleural effusion (arrows).
case_images: cureus-0017-00000076862-i01.jpg
case_images: PMC11787820_01_cureus-0017-00000076862-i01.jpg
case_images: FIG1
case_images: Initial chest radiography showed bilateral asymmetrical pleural effusion (Figure 1).
case_images: Body computed tomography (CT) findings. . (A) Thoracic CT (left panel) showed bilateral pleural effusion (arrows) with passive atelectasis of lung parenchyma and a 3.9 mm calcified granuloma in the right upper lobe posterior segment. No evident adenopathies were registered. (B) Abdominal CT (right panel) revealed moderate volume ascites (*), with thickening and enhancement of peritoneal layers, suggesting inflammatory or infectious peritonitis.
case_images: cureus-0017-00000076862-i02.jpg
case_images: PMC11787820_01_cureus-0017-00000076862-i02.jpg
case_images: FIG2
case_images: A body computed tomography (CT) scan revealed a calcified granuloma in the upper lobe of the right lung, bilateral pleural effusion, moderate volume ascites with peritoneal thickening and contrast enhancement, suggestive of inflammatory or infectious processes (Figure 2).
case_images: 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) findings. . Several hypermetabolic signs (black dots) in infradiaphragmatic adenopathies and in peritoneal layers (arrow) were found.
case_images: cureus-0017-00000076862-i03.jpg
case_images: PMC11787820_01_cureus-0017-00000076862-i03.jpg
case_images: FIG3
case_images: Mammography, gynaecologic and dermatologic examination did not find any malignant lesions. 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) revealed significant hypermetabolic signs in cervical, abdominal, and inguinal adenopathies and peritoneal layers (Figure 3).