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Case 3: Bill Arie

Bill Arie is a 42 year old gentleman with a history of Childs B Cirrhosis secondary to alcoholic liver disease. He presents for a drain of his ascites. On admission, he mentions that he has been experiencing increasing shortness of breath on exertion. You listen to his lungs and notice decreased breath sounds at both bases of his lungs. Chest x-ray demonstrates new bilateral pleural effusions. Pleural tap is undertaken.

Please interpret the results and detail three suitable differential diagnoses

Answer