29th April 2024

A 70-year-old man with a history of chronic kidney disease presents with progressive shortness of breath over the past month and a recent onset of sharp, left-sided chest pain that worsens on taking deep breaths.

A 70-year-old man with a history of chronic kidney disease presents with progressive shortness of breath over the past month and a recent onset of sharp, left-sided chest pain that worsens on taking deep breaths. He denies any recent trauma or infection. On examination, he is tachypneic with reduced breath sounds and dullness to percussion at the left base of his chest. His oxygen saturation is 91% on room air. A chest X-ray reveals a large left-sided pleural effusion.

Which is the most likely underlying diagnosis?