Pleural anthracosis presenting with massive effusion: a rare entity

Pleural anthracosis is rare and, in most cases, is diagnosed incidentally or at autopsy. We report a 67‐year‐old man with pleural anthracosis. He was initially referred for possible tuberculous pleural effusion and had recurrent admissions for symptomatic pleural effusion, which increased with each subsequent episode. A thoracoscopic examination demonstrated diffuse hyperpigmentation in both parietal and visceral pleura. Parietal pleural biopsy indicated granuloma with foreign body giant cell. A contrast‐enhanced computed tomography (CECT) thorax showed focal plaques in parietal pleura with calcifications in the ipsilateral lung. Investigations for tuberculosis, fungal, and malignancy proved to be negative. With these results, a diagnosis of pleural anthracosis was made. This case highlights the unusual presentation of pleural anthracosis with pleural effusion. This article is about a patient with recurrent admissions for symptomatic pleural effusion. Diffuse hyperpigmentation in both parietal and visceral pleural was visualised, and biopsy demonstrated granuloma with foreign body giant cell (anthracosis). This case highlights the unusual presentation of pleural anthracosis with pleural effusion.