Laura Sánchez Torres
Hospital Regional Universitario de Málaga
Monday, 30 December 2019
Pleural effusion and rheumatoid arthritis: Diagnostic value of the microscopic examination of pleural fluid
Figure 1. Cholesterol crystals in pleural fluid in light field at 400 increases to 1/10 dilution.
The image belongs to the pleural fluid (PF) of a 67-year-old man with a history of erosive rheumatoid arthritis (RA), who presented to the emergency department with progressive dyspnea. The chest radiograph performed at admission showed bilateral pleural effusion (PE), so he is admitted for complete his differential study between de novo heart failure or secondary to RA. The patient underwent four days of depletion treatment, after which control radiography showed complete resolution of the right PE and persistence of the left PE. This led to the performance of diagnostic thoracoscopy and evacuation of the persistent PE.