Marked eosinophilia in the pleural fluid associated with pleural rheumatoid nodules. An unusual presentation of rheumatoid disease

We report a case of a 39-year old African-American man with an eosinophilic (86%) pleural effusion. The finding of rheumatoid nodules in the pleura, with positive assays for rheumatoid factor in both the pleural fluid and blood, suggests rheumatoid disease as the etiology, although the patient did not have any articular manifestations. After the removal of the fluid, no reaccumulation occurred during 6 months of follow-up, and arthritis had not yet appeared.