### Presentation to pleural clinic A 52-year-old Medical Secretary was seen in Pleural Outpatient Clinic as follow-up after hospital discharge from the Surgical team 3 weeks previously. Since discharge, the patient had progressive breathlessness with an exercise tolerance of 10 m (previously unlimited) and noted a mild dry cough. She was a lifelong non-smoker. Fevers, sweats or weight loss were not reported. She had no relevant medical or travel history, with no known exposure to asbestos or other chemical agents. Clinical examination was consistent with a large left-sided pleural effusion, which was confirmed on chest radiograph (figure 1A) and thoracic ultrasound. The chest radiograph also demonstrated infiltrates in the left upper zone. Figure 1 (A) Chest radiograph on presentation to Respiratory Outpatient Clinic showing moderate left-sided pleural effusion and left upper zone infiltrate. (B) CT showing SL and HP. (C) HE SL, splenic laceration. ### Previous surgical history The patient originally presented with abdominal pain and non-bloody diarrhoea 4 months prior to her clinic appointment. Routine blood tests were unremarkable, and she was diagnosed with probable infective colitis. She was discharged home with a plan for outpatient colonoscopy if her symptoms continued. Two months following this, the patient re-presented to the surgical team; however, her pain was now epigastric. An abdominal ultrasound was unremarkable, and she was discharged home and her colonoscopy expedited. The patient was readmitted 48 hours following this second discharge and was haemodynamically unstable with an acute abdomen. …

中文翻译：

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顺其自然：诊断富含淋巴细胞的胸腔积液

### 胸膜诊所的介绍 一名 52 岁的医疗秘书在 3 周前从外科团队出院后在胸膜门诊接受了随访。出院后，患者出现进行性呼吸困难，运动耐量 10 m（以前无限制），并出现轻度干咳。她终生不吸烟。没有报告发烧、出汗或体重减轻。她没有相关的医疗或旅行史，也没有接触过石棉或其他化学制剂。临床检查与大量左侧胸腔积液一致，胸片（图 1A）和胸部超声证实了这一点。胸片还显示左上区有浸润。图 1 (A) 呼吸科门诊的胸部 X 光片显示中度左侧胸腔积液和左上区浸润。(B) CT 显示 SL 和 HP。(C) HE SL，脾裂伤。### 既往手术史 该患者最初在就诊前 4 个月出现腹痛和非血性腹泻。常规血液检查无异常，她被诊断出可能患有感染性结肠炎。如果她的症状持续，她出院回家并计划进行门诊结肠镜检查。两个月后，患者再次来到手术团队；然而，她现在的疼痛是上腹痛。腹部超声检查无异常，她出院回家，结肠镜检查加快。患者在第二次出院后 48 小时再次入院，血流动力学不稳定，急腹症。…