Pleural Malignancy Flashcards
What is a pleural effusion?
Abnormal collection of fluid in pleural space
what is a PA CXR?
posterior- anterior chest x-ray
What tests would you take for a pleural effusion?
PA CXR Pleural aspirate Biochemsitry Cytology Culture
what would straw-coloured pleural fluid indicate?
Cardiac failure
hypoalbuminaemia
what would bloody pleural fluid indicate?
Trauma
Malignancy
Infection
Infarction
What would milky pleural fluid indicate?
Empyema
chylothorax
What would foul smelling pleural sample indicate?
Anaerobic empyema
what would food particles in pleural fluid indicate?
oesophageal rupture
whats the first test you would send pleural fluid off to?
Biochemistry
A protein count of >30 d/L indicates?
Transudates
a protein count of <30 g/L indicate?
Exudates
what do cytology look for?
Malignant cells
lymphocytes
neutrophils
what is the major cause of pleural malignancy?
mesothilioma
How do you take a tissue biopsy?
Blind percultaneous pleural biopsy
CT image guided cutting needle pleural biopsy
thoracoscopy
what occupations are related to mesosthelioma?
Builders, shipyard workers etc. who have worked with asbestos
what are symptoms of mesothelioma?
breathlessness chest pain weight loss fever sweating cough
what is asbestosis?
hardening of the lungs as a result of asbestos exposure
what are the three main types of asbestos?
Chrysotile
Amosite
Crocidolite
Why would you image to investigate mesothelioma?
To look for pleural nodularity
circumferential pleural thickening
local invasion
lung entrapment
what would you find in pleural fluid aspiration in mesothelioma?
Low cytological yield
Avoid repeated aspiration
what are some mesothelioma treatments?
pleurodese effusions radiotherapy surgery chemo palliative care
what can cause malignant pleural effusions?
Metastasis of lung cancer (adenocarcinoma?) breast cancer upper GI lymphoma melanoma ovarian etc.
What is talc?
a sclerosing agent
mixed with saline and some other liquids & injected into pleural space
what are side effects of talc pleurodesis?
Minor pleuritic pain & fever Pneumonia Resp. failur talc pneumonitis/ARDS secondary empyema local tumor impplantation at port sitein mesothelioma
when might a pleural catheters be used?
in patients with malignant effusions
What is the LENT score?
LDH
ECOG PS
Neutrophil to lyphocyte ration
Tumour type
What is a primary pneumothorax?
normal lungs
apical bullae rupture
what is a secondary pneumothorax?
underlying lung disease (eg COPD)
