Mesothelial Cell–Rich Tuberculous Pleuroperitoneal Effusion in an Immunocompetent Patient: A Diagnostic Pitfall

Theeb Osama Sulaiman¹, Ebtihal Abdelmoneim Hassan²

Keywords: Tuberculosis, tuberculous pleural effusion, mesothelial cells, ascites, diagnostic pitfall

DOI: 10.63475/yjm.v5i1.0312

DOI URL: https://doi.org/10.63475/yjm.v5i1.0312

Publish Date: 30-04-2026

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Pages: 211 - 214

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Downloads: 19

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Author Affiliation:

1 Specialist, Pulmonology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
2 Consultant, Department of Accident and Emergency, Hamad General Hospital, Doha, Qatar

Abstract

Tuberculous pleural effusion typically presents as an exudative effusion characterized by lymphocytic predominance and a notable scarcity of mesothelial cells, with studies confirming that pleural fluid from tuberculous patients rarely contains more than 5% mesothelial cells. We present a case of an immunocompetent patient who presented with concurrent ascites and rightsided exudative pleural effusion, both featuring elevated mesothelial cell counts. This finding represents a diagnostic pitfall, as high mesothelial cell counts often divert clinical suspicion toward malignancy or acute pleuritis rather than infection. Subsequent investigations, including peritoneal biopsy, confirmed the diagnosis of tuberculosis. The patient was started on antituberculous

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