11th January 2024

A 54-year-old lady presents to the Emergency Department with shortness of breath on exertion, which has worsened over the last 3 months.

A 54-year-old lady presents to the Emergency Department with shortness of breath on exertion, which has worsened over the last 3 months. In addition to this, she has noted some intermittent bloating but no change in bowel habit. A chest x-ray is completed, which shows a right-sided pleural effusion and a diagnostic aspiration is completed. 

Investigations: 

Pleural fluid appearance: straw-coloured. 

Pleural fluid protein: 31g/L. 

Serum protein 67g/L

Pleural fluid LDH 56 units/L

Serum LDH 101 units/L 

M, C + S: Negative gram stain, culture pending. 

Given these results, which of the following is the most likely cause of this patient’s pleural effusion? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.