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Metastatic Squamous Cell Lung Cancer with Underlying Idiopathic Pulmonary Fibrosis

quiko ASQ - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Metastatic Squamous Cell Lung Cancer with Underlying Idiopathic Pulmonary Fibrosis

History: 86 y/o male with PMHX of HTN, Afib, hypothyroidism, idiopathic pulmonary fibrosis, dementia, and depression transferred by his assisted living facility for 3 week hx of decreased PO intake, dry cough, increased confusion, and more recently hypotension. Admitted to the hospital for treatment of bilateral pneumonia and malnutrition.

Findings: CXR: Diffuse opacities throughout bilateral lungs indicative of a fibrotic process. Multiple pulmonary nodules found throughout bilateral lung fields. CT: Multifocal nodular opacities throughout the bilateral lungs concerning for diffuse metastatic disease. Fibrotic changes with a lower lobe predominance at the representing idiopathic pulmonary fibrosis.

Ddx: 1. Metastatic Non-small Cell lung cancer. 2. Metastatic small cell lung cancer. 3. Idiopathic pulmonary fibrosis 4. Pneumoconiosis (such as asbestosis, silicosis etc) this would depend on his exposure. 5. Infection

Dxhow: bronchoscopy and tissue biopsy.

Exam: 86 y/o well developed, but poorly nourished, demented male, who is a poor historian. Does not appear to be in distress, however c/o of cough and poor apetite. Pulm: Bilateral rales, and ronchi. No wheezing, or stridor. CV: Irregular Rate and rythm, no rubs, or gallops, equal pulses X4. Skin: Pale, warm and dry. Abd: NT/ND, + BS throughout. Extremeties: No edema noted, DTRs equal, strength and sensation equal and WNL. Labs: WBC 17.7, HGB 13.4, HCT 40.7, Plt 417. Chem: Na 144, K 3.9, CL 106, CO2 27, BUN 17, Cr1.35, Gluc 92, Alb 2.8 BC X2 Negative for organisms. Resp Cx: Candida Bronchoscopy: Cells consistent with metastatic Squamous Cell Non-small Cell Lung Cancer.

No MeSH data available.


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Metastatic Squamous Cell Lung Cancer with Underlying Idiopathic Pulmonary Fibrosis

quiko ASQ - MedPix (2007)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1575&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Metastatic Squamous Cell Lung Cancer with Underlying Idiopathic Pulmonary Fibrosis

History: 86 y/o male with PMHX of HTN, Afib, hypothyroidism, idiopathic pulmonary fibrosis, dementia, and depression transferred by his assisted living facility for 3 week hx of decreased PO intake, dry cough, increased confusion, and more recently hypotension. Admitted to the hospital for treatment of bilateral pneumonia and malnutrition.

Findings: CXR: Diffuse opacities throughout bilateral lungs indicative of a fibrotic process. Multiple pulmonary nodules found throughout bilateral lung fields. CT: Multifocal nodular opacities throughout the bilateral lungs concerning for diffuse metastatic disease. Fibrotic changes with a lower lobe predominance at the representing idiopathic pulmonary fibrosis.

Ddx: 1. Metastatic Non-small Cell lung cancer. 2. Metastatic small cell lung cancer. 3. Idiopathic pulmonary fibrosis 4. Pneumoconiosis (such as asbestosis, silicosis etc) this would depend on his exposure. 5. Infection

Dxhow: bronchoscopy and tissue biopsy.

Exam: 86 y/o well developed, but poorly nourished, demented male, who is a poor historian. Does not appear to be in distress, however c/o of cough and poor apetite. Pulm: Bilateral rales, and ronchi. No wheezing, or stridor. CV: Irregular Rate and rythm, no rubs, or gallops, equal pulses X4. Skin: Pale, warm and dry. Abd: NT/ND, + BS throughout. Extremeties: No edema noted, DTRs equal, strength and sensation equal and WNL. Labs: WBC 17.7, HGB 13.4, HCT 40.7, Plt 417. Chem: Na 144, K 3.9, CL 106, CO2 27, BUN 17, Cr1.35, Gluc 92, Alb 2.8 BC X2 Negative for organisms. Resp Cx: Candida Bronchoscopy: Cells consistent with metastatic Squamous Cell Non-small Cell Lung Cancer.

No MeSH data available.