The patient died soon after the operation. The post mortem examination revealed a large transitional cell carcinoma arising from the renal pelvis infiltrating the inferior vena cava, a left sided pleural carcinomatosis, and lymphangitic spread to the lung. Although recently questioned 3 malignancy is considered to be a rare finding. The mechanisms involved in eosinophil recruitment into the pleural space are still unclear. However, locally produced IL-5 and probably other cytokines have been shown to attract these cells 4 .
Similar mechanisms seem to be involved in stromal and blood eosinophilia in malignancy.
The 83-year old white female native from Switzerland was admitted for fever, dyspnea at rest, productive cough with purulent sputum, and left sided pleural effusion. Treatment with Clarithromycin did not improve her symptoms. After tachycardic atrial fibrillation and left sided pleural effusion had been detected the patient was admitted to our hospital. In her past medical history she had had a mastectomy four years before admission due to invasive ductal carcinoma with tumor-negative lymph nodes. Three months before admission she was on a cruise on the mediterranean sea visiting northern africa, the middle east, and turkey.