Massive pleural effusion in diffuse granulomatous disease

Although recurrent, massive pleural effusions frequent are associated with malignancy, they rarely occur in granulomatous diseases of the lung. We report the case of a 50-year-old man with a recurrent, massive pleural effusion and a diffuse granulomatous disease that involved the lung, the lymphatics, and bone marrow. The cause of the effusion and granulomatous disease is not entirely clear; however, the effusion did resolve with antifungal therapy and a brief course of corticosteroids.