case_images: PMC6633922_01
case_images: CT of the chest without contrast shows prominent parenchymal ground-glass changes. Large bilateral pleural effusions and moderate pericardial effusion.
case_images: CRIPU2019-9387021.001.jpg
case_images: PMC6633922_01_CRIPU2019-9387021.001.jpg
case_images: fig1
case_images: A week earlier, at an ED visit, he was diagnosed with pneumonia based on CT angiogram of the chest without contrast that showed bilateral pleural effusion and bilateral pulmonary infiltrates (Figure 1).
case_images: Repeat CT thorax without contrast showing moderate-sized right pleural effusion with right lower lobe atelectasis.
case_images: CRIPU2019-9387021.002.jpg
case_images: PMC6633922_01_CRIPU2019-9387021.002.jpg
case_images: fig2
case_images: Repeated CT thorax without contrast showed a moderate right-sided pleural effusion with right lower lobe atelectasis (Figure 2).
case_images: Lymphocytic scintigraphy results of the pelvic area showing no activity beyond the pelvis.
case_images: CRIPU2019-9387021.003.jpg
case_images: PMC6633922_01_CRIPU2019-9387021.003.jpg
case_images: fig3
case_images: Lymphocytic scintigraphy (Figure 3) showed no activity transmitted in the thoracic duct beyond the pelvis suggestive of a central obstruction.
case_images: CT chest and abdomen/pelvis with contrast. Diffuse heterogeneous marrow signal of the thoracic spine and lumbar spine (left). Right kidney has several cysts with the largest measuring 2.8 x 2.9 cm (right). Findings were suggestive of diffuse osteopenia versus bony metastasis.
case_images: CRIPU2019-9387021.004.jpg
case_images: PMC6633922_01_CRIPU2019-9387021.004.jpg
case_images: fig4
case_images: CT Chest/abdomen/pelvis showed bilateral ground-glass opacities within the lungs and possible bony metastasis (Figure 4).
case_images: Whole-body bone scan showing multiple bony metastatic lesions throughout the skeleton.
case_images: CRIPU2019-9387021.005.jpg
case_images: PMC6633922_01_CRIPU2019-9387021.005.jpg
case_images: fig5
case_images: A whole-body bone scan showed multiple bony metastatic lesions throughout the skeleton (Figure 5).
case_images: Venous ultrasound with Doppler of left upper extremity showing findings suggestive of a nonocclusive DVT of proximal/mid left subclavian vein which is difficult to compress.
case_images: CRIPU2019-9387021.006.jpg
case_images: PMC6633922_01_CRIPU2019-9387021.006.jpg
case_images: fig6