21st February 2025

A 69-year-old retired plumber with a history of asbestos exposure is seen in the respiratory clinic after being referred by his GP with a new unilateral pleural effusion.

A 69-year-old retired plumber with a history of asbestos exposure is seen in the respiratory clinic after being referred by his GP with a new unilateral pleural effusion. A CT carried out by the respiratory team demonstrates an area of nodular pleural thickening with mediastinal lymphadenopathy and a moderate unilateral pleural effusion. The pleural effusion is tapped and demonstrates an exudate with no malignant cells seen on cytology.

What is the most appropriate next step in management? 

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