Correct!
3. The enhanced thoracic CT shows extensive interlobular septal thickening and pericardial effusion
The enhanced thoracic CT shows extensive interlobular septal thickening, as seen on the two chest radiographs, as well as a moderate-sized pericardial effusion; the latter accounts for the cardiac enlargement seen at chest radiography. Numerous pulmonary nodules are not seen, and there is no evidence of either aortic dissection or acute pulmonary embolism. A right pleural effusion is present, but no pneumothorax is seen.
Transthoracic echocardiography confirmed the presence of pericardial effusion and suggested tamponade physiology. Pericardiocentesis was performed. The fluid was found to be exudative, but infectious disease studies were unrevealing. An extensive histiocytic infiltration on a background of reactive mesothelial cells was noted on cytological examination.
Which of the following represents the next most appropriate step for the evaluation of this patient? (Click on the correct answer to proceed to the eighth and final page)