Pleural Effusion Massive

Multiple Myeloma

Plasmacytomas

Unilateral homogenous density

Mediastinal shift to right

Left diaphragmatic and left heart silhouettes lost

Left hemithorax larger

Labeled and post tap films below

 

Larger hemithorax
Pleural masses become evident after the fluid is removed and with some air. 

Pleural masses are not clearly evident except for the apical pleural mass.