Unilateral Malignant Pleural Effusion as an Initial Manifestation of Acute Lymphoblastic Leukemia: A Rare Case Report

Unilateral malignant pleural effusion as an initial manifestation that leads to thediagnosis of an underlying acute lymphoblastic leukemia is a rare event. early andaccurate diagnosis of this case is important for prompt and adequate therapy. wepresent the case of an18-year-old male who presented to the emergency departmentwith severe respiratory distress. chest x-ray revealed a unilateral massive right-sidedpleural effusion. cytological examination of the pleural fluid led to the diagnosis ofunderlying acute lymphoblastic leukemia. subsequent hemogram, bone marrowaspirate and flow cytometry analysis confirmed the diagnosis of t-lineage acutelymphoblastic leukemia. the patient underwent induction chemotherapy which led tosignificant clinical improvement due to resolution of the pleural effusion. the patientis on follow up at present. this case report exemplifies and highlights the importanceof cytopathological analysis of body cavity fluids in the diagnosis of underlyingunsuspected malignancies.