A 38-year-old man with underlying transfusion-dependent beta-thalassemia and a history of splenectomy in August 2023 presented in December of the same year, complaining of one month of dyspnoea and orthopnoea. The chest radiograph revealed bilateral pleural effusion, with a left-sided predominance. Diagnostic and therapeutic thoracentesis demonstrated straw-coloured serous pleural fluid (pf) with an exudative biochemical profile (pf protein 53 g/L, pf lactate dehydrogenase 127 U/L), while cytology revealed scattered lymphocytes. The post-thoracentesis chest radiograph revealed a pleural-based, rounded opacity (figure 1). While CT of the thorax is a pragmatic next step of investigation in this case, due to limited access to urgent CT scans at our centre, a decision was made by the treating team to proceed with medical thoracoscopy (MT). The patient underwent MT on the left, during which multiple lobulated masses were visualised along the surface …

中文翻译：

---

内科胸腔镜下观察到的多发性胸腔内髓外造血


一名 38 岁男性，患有潜在的输血依赖性 β 地中海贫血，并于 2023 年 8 月接受过脾切除史，于同年 12 月就诊，主诉一个月呼吸困难和端坐呼吸。胸片显示双侧胸腔积液，以左侧为主。诊断和治疗性胸腔穿刺术显示稻草色浆液性胸水 (pf)，具有渗出性生化特征（pf 蛋白 53 g/L，pf 乳酸脱氢酶 127 U/L），而细胞学检查显示散在淋巴细胞。胸腔穿刺术后胸部 X 光片显示胸膜呈圆形不透明（图 1）。虽然胸部 CT 是本例中务实的下一步调查，但由于我们中心进行紧急 CT 扫描的机会有限，治疗团队决定继续进行内科胸腔镜检查 (MT)。患者在左侧接受了 MT，期间沿表面可见多个分叶状肿块……