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Malignant pleural effusion

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https://www.readbyqxmd.com/read/28344925/chest-drain-size-the-debate-continues
#1
REVIEW
Robert J Hallifax, Ioannis Psallidas, Najib M Rahman
PURPOSE OF REVIEW: Small-bore chest tubes are widely used in the management of common pleural disease. Guidelines suggest that patients with malignant pleural effusions, pneumothorax and pleural infection may be successfully managed with small-bore drains. However, good quality data is often lacking. This article reviews the evidence for the treatment efficacy and potential adverse effects of different chest tube sizes. RECENT FINDINGS: In a large randomised study, the small difference in pain scores between large and small drains was not clinically significant...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28343918/primary-lung-metastasis-of-glioblastoma-multiforme-with-epidural-spinal-metastasis-case-report
#2
Haydn A Hoffman, Charles H Li, Richard G Everson, Jennifer L Strunck, William H Yong, Daniel C Lu
Extracranial metastasis of glioblastoma multiforme (GBM) is rare, but has recently been reported with increasing frequency. GBM metastases typically present after a biopsy or resection of the primary tumor. An otherwise healthy 54year-old woman presented with recurring pleural effusions originally believed to be from a primary lung malignancy. The patient subsequently experienced a generalized tonic clonic seizure and a right temporal brain mass was discovered. The patient later developed weakness and radiculopathy, and an extramedullary extradural mass spreading from C7 to T6 was discovered...
March 23, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28343002/pulmonary-metastatic-angiosarcoma-from-scalp-with-fatal-complication-a-case-report
#3
Yung-Sheng Cheng, Tim-Mo Chen, Wen-Chiuan Tsai, Tsai-Wang Huang
INTRODUCTION: Angiosarcoma is a rare malignant neoplasm with poor prognosis. Angiosarcoma of the scalp is frequently recurs locally, and metastasizes early despite various treatments. The common sites of metastatic are lung, liver, and lymph nodes. Pulmonary metastasis with hemoptysis and pneumothorax is rare but threatening. PRESENTATION OF CASE: A 77-year-old male had recurrent angiosarcoma of the scalp even with post operation radiotherapy. At the same time, recurrent pneumothorax was noted, thus he underwent wedge resection of the right upper lobe of the lung plus pleural biopsy...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28337699/lung-ultrasound-is-comparable-with-chest-roentgenogram-for-diagnosis-of-community-acquired-pneumonia-in-hospitalised-children
#4
Krishna Kumar Yadav, Shally Awasthi, Anit Parihar
OBJECTIVE: To evaluate the accuracy of lung ultrasound (LUS) in comparison to chest roentgenogram (CXR) in hospitalised children with community-acquired pneumonia (CAP). METHODS: This study was a hospital based prospective observational study, conducted between January 2014 and December 2014. Hospitalised children aged 2 to 59 mo with community-acquired pneumonia were included in the study. The informed written consent was taken from parents (or legal guardian) before recruitment...
March 24, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28331796/an-unexpected-finding-in-a-man-with-multiple-pulmonary-nodules-a-pleural-effusion-and-respiratory-failure
#5
Yik Lam Pang, Quentin Jones
We report the case of a 47-year old Caucasian man with a history of depression and high alcohol intake who presented with a one-month history of weight loss, dry cough and abdominal pain. He had no smoking history of note. The patient was treated for a suspected chest infection, however developed respiratory failure and was intubated. A CT showed multiple pulmonary nodules, left pleural thickening extending to the mediastinum and bilateral pleural effusions-larger on the left, suggestive of disseminated malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28326798/indwelling-pleural-catheters-for-patients-with-hematologic-malignancies-a-14-year-single-center-experience
#6
Saadia A Faiz, Priyanka Pathania, Juhee Song, Liang Li, Diwakar D Balachandran, David E Ost, Rodolfo C Morice, Vickie R Shannon, Lara Bashoura, George A Eapen, Carlos A Jimenez
RATIONALE: Placement of an indwelling pleural catheter is an established modality for symptom relief and pleurodesis in the treatment of malignant pleural effusion. Concerns remain regarding possible infectious complications, risk of hemorrhage, and the rate of pleurodesis with the use of pleural catheters in the treatment of hematologic malignancies. OBJECTIVES: The goals of our study were: (1) to evaluate the safety and cumulative incidence of pleurodesis with indwelling pleural catheters for patients with hematologic malignancies; and (2) to evaluate overall survival of this cohort of patients with pleural effusions...
March 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28321070/primary-malignant-lymphoma-originating-from-the-chest-wall-without-preceding-pleural-disease
#7
Yumi Iwasa, Asuka Okada, Hideaki Takenaka, Terukazu Takahashi, Nobuo Koguchi, Kumiko Katayama, Shinsuke Murakami, Sumito Choh, Koichi Tomoda, Hiroshi Kimura
An 84-year-old woman presented to our hospital with dyspnea on exertion and left back pain. Chest X-ray and chest computed tomography (CT) revealed an irregular pleural mass invading her left chest wall with rib destruction and pleural effusion. CT-guided needle biopsy revealed diffuse large B-cell lymphoma. Low-dose oral etoposide produced a complete response, and she continued oral chemotherapy for one year after the diagnosis and maintained good performance status. We herein report a very rare case of non-pyothorax-associated lymphoma that nonetheless resulted in great recovery...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#8
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28316788/chemical-pleurodesis-using-mistletoe-extracts-via-spray-catheter-during-medical-thoracoscopy-for-management-of-malignant-pleural-effusion
#9
Jung Seop Eom, Tae Hwa Kim, Geewon Lee, Hyo Yeong Ahn, Jeong Ha Mok, Min Ki Lee
We present three cases of successful chemical pleurodesis with a liquid solution of mistletoe extract using a spray catheter during medical thoracoscopy. The medical thoracoscopy was performed in all presented cases to remove pleural effusion and conduct chemical pleurodesis to manage symptomatic malignant pleural effusion. A spray catheter was used to instil the mistletoe extract evenly into the pleural cavity, and there were no pleurodesis-related complications. Respiratory symptoms caused by pleural effusion improved after pleurodesis, and successful pleurodesis was maintained for more than 3 months after medical thoracoscopy in all three patients...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28314308/comparison-of-the-diagnostic-performance-of-fibulin-3-and-mesothelin-in-patients-with-pleural-effusions-from-malignant-mesothelioma
#10
Enrico Battolla, Pier Aldo Canessa, Paola Ferro, Maria Cristiana Franceschini, Vincenzo Fontana, Paolo Dessanti, Valentina Pinelli, Anna Morabito, Franco Fedeli, Maria Pia Pistillo, Silvio Roncella
BACKGROUND: In the literature, there exist conflicting data on the value of fibulin-3 (FBLN3) for the diagnosis of pleural effusion (PE) in malignant pleural mesothelioma (MPM). Therefore we compared the diagnostic performance of FBLN3 against that of soluble mesothelin-related peptide (SMRP) in a cohort of Italian patients. MATERIALS AND METHODS: FBLN3 and SMRP were detected in PE from 33 patients with MPM, 64 with pleural benign lesions and 23 with non-MPM pleural metastases using a commercial enzyme-linked-immunosorbent(ELISA)-assay kit according to manufacturers' instructions...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28306520/assessment-of-real-time-pcr-method-for-detection-of-egfr-mutation-using-both-supernatant-and-cell-pellet-of-malignant-pleural-effusion-samples-from-non-small-cell-lung-cancer-patients
#11
Saeam Shin, Juwon Kim, Yoonjung Kim, Sun-Mi Cho, Kyung-A Lee
BACKGROUND: EGFR mutation is an emerging biomarker for treatment selection in non-small-cell lung cancer (NSCLC) patients. However, optimal mutation detection is hindered by complications associated with the biopsy procedure, tumor heterogeneity and limited sensitivity of test methodology. In this study, we evaluated the diagnostic utility of real-time PCR using malignant pleural effusion samples. METHODS: A total of 77 pleural fluid samples from 77 NSCLC patients were tested using the cobas EGFR mutation test (Roche Molecular Systems)...
March 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28289860/the-pd-l1-pd-1-pathway-promotes-dysfunction-but-not-exhaustion-in-tumor-responding-t-cells-from-pleural-effusions-in-lung-cancer-patients
#12
Heriberto Prado-Garcia, Susana Romero-Garcia, Alejandra Puerto-Aquino, Uriel Rumbo-Nava
Malignant pleural effusions are frequent in patients with advanced stages of lung cancer and are commonly infiltrated by lymphocytes and tumor cells. CD8+ T cells from these effusions have reduced effector functions. The programmed death receptor 1(PD-1)/programmed death ligand 1 (PD-L1) pathway is involved in T-cell exhaustion, and it might be responsible for T-cell dysfunction in lung cancer patients. Here, we show that PD-L1 is expressed on tumor cell samples from malignant effusions, on lung cancer cell lines, and, interestingly, on MRC-5 lung fibroblasts...
March 13, 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/28287043/healthcare-and-economic-burden-of-adverse-events-among-patients-with-chronic-myelogenous-leukemia-treated-with-bcr-abl1-tyrosine-kinase-inhibitors
#13
Jay Lin, Dinara Makenbaeva, Melissa Lingohr-Smith, Robyn Bilmes
OBJECTIVES: BCR-ABL1 tyrosine kinase inhibitors (TKIs) are established treatments for chronic myelogenous leukemia (CML); however, they are associated with infrequent, but clinically serious adverse events (AEs). The objective of this analysis was to assess healthcare resource utilization and costs associated with AEs, previously identified using the FDA Adverse Event Reporting System (FAERS) in another study, among TKI-treated patients. METHODS: Adult patients with ≥1 inpatient or ≥2 outpatient ICD-9-CM diagnosis codes for CML and ≥1 claim for a TKI treatment between January 1, 2006 and September 30, 2012 were identified from the Commercial and Medicare MarketScan databases...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28285961/immunocytochemical-expression-of-a-panel-of-markers-in-pleural-effusions-from-patients-with-primary-lung-adenocarcinoma
#14
Eleftheria Chaini, Anna-Maria Athanassiadou, Antonis Vassias, Angelos Tsipis, Maria Gonidi, Kyriakos D Hainis, Andrianni Charpidou, Pauline Athanassiadou
INTRODUCTION: This study's principal objective was to evaluate the critical role of the application of immunocytochemistry to a novel panel of diagnostic markers for the accurate detection of the source of malignancies in pleural effusions of lung adenocarcinoma. MATERIALS AND METHODS: In 40 effusion smears from lung adenocarcinoma, the expression of the E-cadherin, a-catenin, Thyroid Transcription Factor (TTF-1), Epidermal Growth Factor Receptor (EGFR), p53, caspase 9 and 3, Bax and Bcl-2 was examined by immunocytochemistry...
February 7, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28284315/long-term-outcome-of-patients-with-nonspecific-pleurisy-at-medical-thoracoscopy
#15
Yuan Yang, Yan-Bing Wu, Zhen Wang, Xiao-Juan Wang, Li-Li Xu, Zhao-Hui Tong, Huan-Zhong Shi
BACKGROUND: Medical thoracoscopy is an effective and safe procedure for diagnosing pleural effusions of undetermined causes. But there are still a part of patients with pleural effusions were diagnosed as nonspecific pleurisy when no specific biopsy results were found after undergoing thoracoscopic biopsy. The long-term outcome of these patients is unclear, and anxieties about undiagnosed malignancy persist. METHODS: Between July 2005 and June 2014, medical thoracoscopy using the semi-rigid instrument was performed and pleural biopsy was taken in 833 patients with pleural effusions...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28275489/medical-thoracoscopy-in-china-the-present-status-and-the-future
#16
REVIEW
Jing-Yuan Liu, Liang Xiong, Min Zhang, Shi-Yuan Shuai, Xiao-Shan Wei, Lin-Lin Ye, Qiong Zhou
Medical thoracoscopy (MT) refers to a minimally invasive procedure to inspect and perform a biopsy of the pleural space, as well as to perform therapeutic interventions, in a nonintubated patient under local anesthesia. This procedure provides the physician a window into the pleural space. Over the past two decades, MT has been developed very rapidly in China. We performed a review of the published data on MT in China, and estimated the present status, the challenges, and future perspectives of MT. From the data we conduct that MT is widely used well in China, not only in the diagnosis of exudative pleural effusions, but also in the management of pleural diseases, such as tuberculous pleural effusion, malignant pleural effusion and spontaneous pneumothorax...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28272659/non-hodgkin-lymphoma-and-pleural-mesothelioma-in-a-person-exposed-to-asbestos
#17
Claudio Bianchi, Tommaso Bianchi
Non-Hodgkin lymphoma and pleural mesothelioma may co-exist in the same patient. A large cell non-Hodgkin lymphoma of the inguinal lymph nodes was diagnosed in a 73-year-old woman. The patient was treated by chemotherapy. She did not receive radiotherapy. The patient had been exposed to asbestos having worked in a cotton mill and in a distillery. Four years after the diagnosis of lymphoma, she presented with a left pleural effusion. Large biopsies of the pleura showed a malignant mesothelioma, biphasic type, and pleural plaques...
February 4, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28271728/comparing-approaches-to-the-management-of-malignant-pleural-effusions
#18
José M Porcel, Macy Mei-Sze Lui, Andrew D Lerner, Helen E Davies, David Feller-Kopman, Y C Gary Lee
Management of symptomatic malignant pleural effusions is becoming more complex due to the range of treatment options, which include therapeutic thoracenteses, thoracoscopic talc pleurodesis, bedside pleurodesis with talc or other sclerosing agents via small-bore chest catheters, indwelling pleural catheters, surgery, or a combination of some of these procedures. Areas covered: Recent advances for the expanding range of treatment options in malignant pleural effusions are summarized, according to the best available evidence...
March 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28271362/mesothelioid-reaction-following-talc-pleurodesis-a-case-report
#19
Tatyana Faynberg, Neha Patel, Amrit P Nayar, Alan J Shienbaum
INTRODUCTION: Talc pleurodesis is a well-established procedure performed to obliterate the pleural space to prevent recurrent pleural effusion and/or recurrent pneumothorax. Pleurodesis is commonly accomplished by draining the pleural fluid, if present, followed by either a mechanical procedure, such as abrasion, pleurectomy, or instillation of a chemical irritant into the pleural space, which results in inflammation and fibrosis which obliterates the pleural space. The reported complications of talc pleurodesis are hypoxemia, hypotension, tachycardia, dyspnea, chest pain, and fever...
March 7, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28248731/aberrant-cytokeratin-20-reactivity-in-epithelioid-malignant-mesothelioma-a-case-report
#20
Rashmi Manur, Ihab Lamzabi
Malignant mesothelioma is an uncommon neoplasm that should be distinguished from the more common pulmonary adenocarcinomas and other metastatic lesions. Although diagnosis is based on morphologic features, immunohistochemical stains such as Calretinin, WT-1, CK-5/6, D2-40, Ber-Ep4, and MOC-31 are routinely used. Other organ-specific immunohistochemical markers are used when metastases from unknown primary lesion is suspected clinically. Here, we report a case of pleural epithelioid malignant mesothelioma expressing CK20...
February 28, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
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