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  Indian J Med Microbiol
 

Figure 4: Performing pleural manometry to assist ultrasound-guided biopsy of lung mass. (a-e) Shows images from a 61-year-old female who presented with dyspnea of 2-week duration. She had earlier presented elsewhere where chest X-ray posteroanterior view (a) showed right massive pleural effusion with mediastinal shift to the contralateral side. (b) Chest X-ray taken after attempted aspiration of 1.5 L of pleural effusion in the absence of pleural manometry shows right hydropneumothorax. (c) Contrast-enhanced computed tomogram chest at the level of ventricular chambers shows right hydropneumothorax with underlying lung mass and subcarinal lymphadenopathy. (d) Chest X-ray taken a week later when she presented to me. The air pocket in the pleural space had apparently got absorbed. (e) Chest X-ray taken after draining 1400 ml of pleural fluid under pleural pressure monitoring. The medial margin of the right lower lung mass is well defined. (f) Pleural elastance curve on the removal of 1400 ml of pleural effusion. Pleural pressure dropped suddenly to −6 cm H2O and the patient developed chest pain and the procedure was stopped. Following which, the lung mass was visualized nearer to the chest wall on ultrasound and biopsy was performed under ultrasound guidance. Histopathology revealed adenocarcinoma and pleural fluid cytology revealed atypical cells

Figure 4: Performing pleural manometry to assist ultrasound-guided biopsy of lung mass. (a-e) Shows images from a 61-year-old female who presented with dyspnea of 2-week duration. She had earlier presented elsewhere where chest X-ray posteroanterior view (a) showed right massive pleural effusion with mediastinal shift to the contralateral side. (b) Chest X-ray taken after attempted aspiration of 1.5 L of pleural effusion in the absence of pleural manometry shows right hydropneumothorax. (c) Contrast-enhanced computed tomogram chest at the level of ventricular chambers shows right hydropneumothorax with underlying lung mass and subcarinal lymphadenopathy. (d) Chest X-ray taken a week later when she presented to me. The air pocket in the pleural space had apparently got absorbed. (e) Chest X-ray taken after draining 1400 ml of pleural fluid under pleural pressure monitoring. The medial margin of the right lower lung mass is well defined. (f) Pleural elastance curve on the removal of 1400 ml of pleural effusion. Pleural pressure dropped suddenly to −6 cm H<sub>2</sub>O and the patient developed chest pain and the procedure was stopped. Following which, the lung mass was visualized nearer to the chest wall on ultrasound and biopsy was performed under ultrasound guidance. Histopathology revealed adenocarcinoma and pleural fluid cytology revealed atypical cells