Diagnosis particularities of lung cancer in a young patient without external risk factors – A case report

Abstract Lung cancer is the most common type of cancer worldwide, smoking being the strongest risk factor. We present the case of a non-smoker, a 23-year-old patient, without environmental exposure or personal pathological history, who was hospitalised for dry cough, a unique episode of haemoptysis and low-graded fever. He was admitted with a left basal diminished vesicular murmur, without detectable rales, and normal oxygen saturation. The chest X-ray highlighted left pleural effusion in a medium amount. A chest ultrasound revealed also an adjacent pulmonary consolidation. The cytological examination of the pleural fluid detected the presence of lymphocytes 36%, eosinophils 25%, polymorphonuclear 39% and frequent red blood cells. Angio-computer tomography confirmed the existence of a left hilar tumour formation with a mass effect on the hilar structures, possibly a few tumoral emboli in the lateral and posterior basal segmentary arteries, a lower left lobe consolidation, a left pleural effusion with hydroaeric level, and a left pneumothorax. The patient required a fibre bronchoscopy that showed us a proliferative infiltrative process, stenosis of the left lower bronchia, and extrinsic compression of the left lower lobe and the 6th segment. Infiltration of mucosa at the left basal pyramid was also detected. The histological examination argued for pulmonary adenocarcinoma. The particularities of the case consist of the lack of exposure to known risk factors for bronchopulmonary neoplasm and the early appearance of lung cancer and its complications in a young patient.

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Refractory pleural effusion as a rare complication of pulmonary vascular stenosis induced by fibrosing mediastinitis: a case report and literature review

Journal of International Medical Research ◽

10.1177/03000605211010073 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110100

Author(s):

Suqiao Yang ◽

Jianfeng Wang ◽

Jifeng Li ◽

Kewu Huang ◽

Yuanhua Yang

Keyword(s):

Pleural Effusion ◽

Rare Complication ◽

Clinical Manifestations ◽

Pulmonary Vein Stenosis ◽

Pulmonary Artery Stenosis ◽

Heart Catheterization ◽

Tissue Mass ◽

Fibrosing Mediastinitis ◽

Extrinsic Compression ◽

Left Pleural Effusion

Fibrosing mediastinitis (FM) is a progressive, life-threatening disease characterized by extrinsic compression of mediastinal bronchovascular structures, and the clinical manifestations largely depend upon the affected structures. Pleural effusion is rarely reported in patients with FM. We herein describe a 70-year-old man who presented with recurrent breathlessness and refractory left pleural effusion. He was misdiagnosed with and treated for tuberculous pleurisy for several months. Thoracentesis revealed a transudative pleural effusion, and a contrast-enhanced computed tomography scan of the thorax showed an extensive mediastinal soft tissue mass consistent with FM. Pulmonary angiography demonstrated pulmonary artery stenosis on the right side and pulmonary vein stenosis mainly on the left side. After measurement of the pulmonary arterial pressure by right heart catheterization, the patient was diagnosed with pulmonary hypertension associated with FM. He underwent balloon angioplasty and stent implantation of the stenosed pulmonary vessels, which led to long-term improvement in his breathlessness and pleural effusion. Our systematic review of the literature highlights that pleural effusion can be an uncommon complication of FM and requires careful etiological differentiation.

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Risk Factors for and Time to Recurrence of Symptomatic Malignant Pleural Effusion in Patients with Metastatic Non-Small Cell Lung Cancer with EGFR or ALK Mutations

CHEST Journal ◽

10.1016/j.chest.2020.10.081 ◽

2020 ◽

Author(s):

Audra J. Schwalk ◽

David E. Ost ◽

Sahara N. Saltijeral ◽

Henriette De La Garza ◽

Roberto F. Casal ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Pleural Effusion ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Malignant Pleural Effusion ◽

Small Cell ◽

Small Cell Lung ◽

Time To Recurrence

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Thoracic radiation-induced pleural effusion and risk factors in patients with lung cancer

Oncotarget ◽

10.18632/oncotarget.18824 ◽

2017 ◽

Vol 8 (57) ◽

pp. 97623-97632 ◽

Cited By ~ 4

Author(s):

Jing Zhao ◽

Regina M. Day ◽

Jian-Yue Jin ◽

Leslie Quint ◽

Hadyn Williams ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Pleural Effusion ◽

Thoracic Radiation ◽

Radiation Induced

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Development of pulmonary embolism in a nonhospitalized patient with COVID-19 who did not receive venous thromboembolism prophylaxis

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa286 ◽

2020 ◽

Vol 77 (23) ◽

pp. 1957-1960

Author(s):

Ellen M Uppuluri ◽

Nancy L Shapiro

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Chest Pain ◽

Young Patient ◽

Lower Lobe ◽

Thromboembolism Prophylaxis ◽

Vte Prophylaxis ◽

Thrombotic Complications

Abstract Purpose Coronavirus disease 2019 (COVID-19) has been associated with thrombotic complications such as stroke and venous thromboembolism (VTE), and VTE prophylaxis for hospitalized patients with COVID-19 is recommended. However, extended postdischarge VTE prophylaxis and VTE prophylaxis for nonhospitalized patients with COVID-19 are not routinely recommended due to uncertain benefit in these populations. Summary Here we report development of a pulmonary embolism (PE) in a young patient without other VTE risk factors who was treated for COVID-19 in an emergency department (ED) and discharged home without VTE prophylaxis, which was consistent with current recommendations. The patient presented to the ED 12 days later with complaints of chest pain for 1 day and was found to have a PE within the segmental and subsegmental branches of the left lower lobe. Conclusion This case suggests that nonhospitalized patients with COVID-19 may be at higher risk for VTE than patients with other medical illnesses and warrants further research into the risk of VTE in outpatients with COVID-19.

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Severe Pulmonary Infection in a 20-Month-Old Female

Case Reports in Infectious Diseases ◽

10.1155/2020/7301617 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Yasmeen Mann ◽

Paul Zeller ◽

Kristen Carrillo-Kappus ◽

Melissa Victor ◽

Mary Moore

Keyword(s):

Pleural Effusion ◽

Chest Tube ◽

Intraoperative Complications ◽

Lower Lobe ◽

Tube Placement ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Left Pleural Effusion ◽

Bacterial Organism

Community-Acquired Pneumonia (CAP) is a common reason for hospitalization of a pediatric patient. We report a 20-month-old female admitted for suspected CAP. History included a week-long cough, fever, dyspnea, single occurrence of seizure-like activity, and a sick contact. Initial chest X-ray (CXR) showed left lower lobe pneumonia and parapneumonic effusion with a complex left pleural effusion. Ultrasound findings prompted the need for contrast-enhanced computed tomography (CT) of the chest. Contrast-enhanced CT of the chest confirmed a large pleural effusion with major atelectasis and mediastinal shift. The patient was treated with empiric antibiotics, video-assisted thoracoscopic surgical (VATS) decortication of empyema, and chest tube placement. Due to intraoperative complications, the VATS decortication was aborted and patient was transferred to the pediatric intensive care unit (PICU). A thoracentesis with culture failed to isolate a bacterial organism. Dexamethasone was started after repeat CXR showed persistent infiltrate. Subsequent contrast-enhanced CT of the chest showed a large collection of air and persistent consolidation. The patient received repeat VATS decortication and reinsertion of a chest tube. Repeat pleural fluid cultures failed to isolate a bacterial organism. Infectious disease (ID) consult recommended linezolid 140 mg Q8H for 4 weeks. Seven days after second VATS, a respiratory pathogen panel was positive for rhinovirus/enterovirus. With resolution of leukocytosis and clinical improvement, the patient was discharged with the chest tube in place and pediatric surgery outpatient follow-up. After three months, sequalae from both the infection and interventions presented .

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A Rare Case of Bronchial Anthracofibrosis with Pleural Anthracosis Presented as Recurrent Pleural Effusion

Case Reports in Pulmonology ◽

10.1155/2019/2982763 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Rajesh Kumar Yadav ◽

Jitendra Kumar Saini ◽

Prabhpreet Sethi ◽

Rohit Sarin

Keyword(s):

Pleural Effusion ◽

Lower Lobe ◽

Middle Lobe ◽

Left Lower Lobe ◽

Second Hand Smoke ◽

Parietal Pleura ◽

Lobe Bronchus ◽

Breath Sounds ◽

Left Pleural Effusion ◽

Cardiac Evaluation

A fifty-eight-year-old, nonsmoker Indian male presented with recurrent left pleural effusion. He had history of dry cough, exertional breathlessness for the last two years. He denied any occupational exposure or second hand smoke exposure. His physical examination demonstrated decreased breath sounds on the left side of chest. Cardiac evaluation was unremarkable. Diagnostic pleural aspiration revealed straw coloured fluid, exudative, and nonmalignant in nature. CT-imaging of the chest demonstrated left pleural effusion, nodular parenchymal infiltrates in bilateral lungs, plate like atelectasis in the left lower lobe. Bronchoscopy showed diffuse airway pigmentation, right middle lobe opening, and left lower lobe bronchus pigmented and stenosed. Semi-rigid pleuro-videoscopy revealed diffuse black coloured deposits over visceral pleura and focally scattered deposits over parietal pleura. Spirometry showed mild airway obstruction with moderate impairment in diffusion capacity.

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Lung carcinogens

Russian Journal of Occupational Health and Industrial Ecology ◽

10.31089/1026-9428-2019-59-9-834-835 ◽

2020 ◽

pp. 834-834

Author(s):

A. . Olsson

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Western Europe ◽

Smoking Prevalence ◽

Occupational Risk Factors ◽

Common Cancer ◽

The Russian Federation ◽

Global Patterns ◽

External Risk ◽

Over Time

Lung cancer is the most common cancer globally, with more than 2 million new cases per year. It is also the cancer that causes most deaths, i.e. about 1.7 million annually or 18% of all cancer deaths. In the Russian Federation, lung cancer is the most common cancer among men, while still relatively rare among women. In Northern and Western Europe, lung cancer rates in men have decreased in the last 20 years, while the rates in women keep rising. These global patterns are largely influenced by the national smoking prevalence in the previous decades for respective sex. Environmental and occupational risk factors also contribute to the burden of lung cancer, but the extent of this contribution varies over time and by location. There is a large potential for preventing lung cancer development by reducing and eliminating external risk factors.

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