Multiple neck swelling

65 y/o M with the c/o of multiple neck swellings for 6 months, associated with fever, night sweats. Excisional biopsy was done under GA, immediately after extubation his saturation was decreased to 70% accompanied by severe dyspnea During re-intubation large amount of frothy secretions was suctioned through the endotracheal tube. Lab tests were positive for High D-Dimer in 6000 despite rapid assessments with color doppler of lower limb vein were negative, other parameters normal. A large dose of diuretics was given & 8 hours later the patient extubated, his saturation improved to 90% CXRs were taken immediately after extubation & second after 8 hours, showing a marked decrease in the infiltration. This was a case of Negative pressure pulmonary edema.

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Yes 1st xray shows spiral trachea And bilateral pulmonary oedema Aspiration sucked out And diuretics help in reducing the pulmonary oedema as in 2nd xray Question is high D-dimer suggest tromboemolism or coagulation disease Pt has cervical lymphadenopathy My suspicion r/o leukaemia
Thanx dr Pushkar ji Bhomia
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Thanks Dr Sandeep Ghodekar
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