Miguel Ortiz is a Pulmonary and Critical Care Physician, Gabriela Montes is a Physician, Onix Cantres is a Pulmonologist, and William Rodríguez is Chief, Pulmonary and Critical Care Medicine and Training Program Director, all at VA Caribbean Health Care System in San Juan, Puerto Rico. Correspondence: William Rodríguez (william-rodriguez@va.gov)
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
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In addition, other techniques, such as somatostatin- receptor imaging are specifically beneficial in tumors that express the somatostatin receptor. 16 For this reason, this type of study is typically indicated in patients with known metastasis, not in patients with low-grade tumors. Abdominal CT scans are done because the liver is a common site for metastasis.
Our case report demonstrates how biomarkers help diagnose these potentially aggressive and life-threatening tumors that may present as a common condition such as a pleural effusion. Using a less invasive and quicker approach with thoracentesis rather than with lung biopsies is a diagnostic tool in this entity. IHC in cell blocks is a reasonable diagnostic method especially in patients in whom performing a lung biopsy is difficult.
Conclusions
The presence of a symptomatic and recurrent unilateral pleural effusion must urge physicians to consider thoracentesis with mindful use of biomarkers not only for therapeutic purposes, but also for diagnosis of a variety of etiologies, both benign and malignant.