Intended for healthcare professionals

Endgames Spot Diagnosis

Breathlessness and abdominal swelling: a classic eponymous syndrome

BMJ 2017; 356 doi: (Published 09 February 2017) Cite this as: BMJ 2017;356:j382
  1. Jennifer Kahan, clinical fellow in oncology,
  2. Russell Banner, consultant clinical oncologist,
  3. Kerryn Lutchman-Singh, consultant in obstetrics and gynaecology
  1. Singleton Hospital, Sketty Lane, Swansea, UK
  1. Correspondence to J Kahan Jennifer.Kahan{at}

A previously well 50 year old woman developed shortness of breath over several weeks accompanied by abdominal distension and discomfort. She was unable to lie flat due to orthopnoea. She had no comorbidities and was on no medication. A computed tomography (CT) scan of the chest, abdomen, and pelvis was undertaken, followed by biopsy and definitive surgical treatment. Postoperative histology confirmed a benign neoplasia. What are the three main radiological findings seen in the CT image (fig 1) and what is the eponymous diagnosis associated with this classic triad?

Fig 1

Coronal computed tomography (CT) image of the chest, abdomen, and pelvis

Short answer

The CT shows a large right pleural effusion …

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