The utility of pleural amylase measurement in metastatic mucinous adenocarcinoma

We describe a case of exudative pleural effusion in a patient with mucinous pulmonary adenocarcinoma. Pleural fluid examination showed markedly raised amylase with normal serum amylase concentration. There was no clinical or radiological evidence of oesophageal rupture or pancreatitis. The case illustrates the importance of considering pulmonary malignancy in the context of amylaserich pleural effusion. Causes of amylase-rich pleural effusion and the significance of isoenzyme analysis are discussed.

Significant resolution of tuberculous pleural effusion on chemotherapy alone

Background: As a standard, significant pleural effusion, whether tuberculous (TB) or not, requires therapeutic thoracocentesis. We tested the hypothesis that standard anti-TB chemotherapy alone can resolve significant pleural effusion.

Methods: 20 eligible patients with TB pleural effusion of at least 30% of the hemithorax (10 with moderate-size and 10 with large-size effusion, respectively) were retrospectively reviewed for radiological resolution of their effusions at two, six and 12 months after commencement of standard six-month therapy.

A rare case of chronic benign tracheo-oesophageal fistula, with Candida albicans cultured from a pleural effusion

We present a case of chronic benign tracheo-oesophageal fistula in an immunologically competent elderly female, cured with a period of nasogastric feeding.

Keywords Benign chronic tracheo-oesophageal fistula, pleural effusion, Candida albicans

Declaration of Interests Dr Stride has received payment as a speaker for pharmaceutical companies Amgen, Sanofi and MSD.