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Case 2: Ira Itis

Ira Itis is an 85 year old lady who has presented with increasing shortness of breath on exertion and pedal oedema. She denies any chest pain but tells you that her symptoms have been progressively getting worse over the last few months. A chest x-ray shows large bilateral pleural effusions. Your registrar performs a pleuritic tap and the results are shown as below.

Please interpret the results and detail three suitable differential diagnoses.

Answer