Dark Streaks and Yellow Exudates: Pleuroscopic Clues in Recurrent Post-Traumatic Pleural Effusion.

Thoracic splenosis is a well-documented yet clinically elusive sequela of combined splenic rupture and diaphragmatic trauma, classically presenting years after initial injury as unexplained pleural effusions or dark hypervascular pleural nodules. This case illustrates a critical diagnostic pitfall: small superficial forceps biopsies of suspected ectopic splenomas routinely harvest only the reactive fibrous capsule, yielding non-specific inflammatory histology that can obscure unconfirmed thoracic splenosis while requiring careful differentiation from tuberculous pleuritis and pleural malignancy.