Malignant pleural effusion

This patient with a history of breast cancer (note the right mastectomy), and currently undergoing chemotherapy (note the portacath), presented with progressive dyspnoea. CXR shows a moderate left pleural effusion – in the setting of a known malignancy, a unilateral pleural effusion needs to be considered suspicious for metastatic disease until proven otherwise. Ultrasound-guided pleural tap confirmed that this effusion was a malignant one.