Although recurrent, massive pleural effusions frequently are associated with malignancy, they rarely occur in granulomatous diseases of the lung. We report the case of a 50-year-old man with a recurrent, massive pleural effusion and a diffuse granulomatous disease that involved the lung, the lymphatics, and bone marrow. The cause of the effusion and granulomatous disease is not entirely clear; however, the effusion did resolve with antifungal therapy and a brief course of corticosteroids.
