Concluded Case

CA Lung with metastasis

50-year old male, with h/o recurrent effusion presented with right chest pain for 2 months duration. Associated with loss of weight. No h/o hemoptysis, dyspnea, fever, loss of appetite. No h/o chronic illness in the past. No h/0 smoking H/0 ICD insertion twice ( Drained around 4l of serous fluid in two months) Malignant cytology for pleural fluid is negative. CBNAAT - Negative Chest xray -right massive pleural effusion Cect thorax and abdomen- right massive effusion with lung collapse. No other findings noted. Abdomen -NAD. He underwent right Uniportal-VATS, mobilisation of lung and pleurodesis. Intraoperative findings is attached. Kindly provide differential diagnosis and comment on further management

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Concluded answer

HPE was suggestive ca lung with metastasis

All Answers

Wel managed case sir. Few fibroric bands, nodular and cystic lesions seen on thoracoscopic view. TB Hydatid cysts Mesothelioma are the possible DDs. HPE will be helpful in concluding. Plz update the case sir. Thanks for sharing.

1st xray shows hydrothorax rt side Lt side hyperinflated Mediastinum pushed to lt Post pleurodesis suggest discreet floppy infiltrates all over rt chest More in rt lower zone Thoracoscopy shows granulomas and fibrotic strands D/d 1 tuberculosis 2 malignancy

Thanx dr Mansukh Shah
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

D/D Mesothelioma Sarcoidosis SLE or other collagen disease like Rheumatoid arthritis Hydatid cyst

HPE was suggestive ca lung with metastasis

Nice presentation Very well managed

CA lung, tuberculosis If both negative,then think about lymphoma and connective tissue disorders

Pul tuberculosis

D/Dx 1. Tuberculosis 2. Malignancy Rule out any lymphadenopathy, if present then go for FNAC/BIOPSY

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