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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.


There are too numerous to count multifocal nodular opacities throughout bilateral lung slices.  Diffuse interlobular septal thickening and peribronchial cuffing noted, predominantly in the lung bases.  Honeycombing and fibrotic changes are also present bilaterally.  There is a small left pleural effusion.   Mediastinal adenopathy is present to include the pretracheal, paratracheal, AP window and subcarinal chains
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MPX1575_synpic39398: There are too numerous to count multifocal nodular opacities throughout bilateral lung slices. Diffuse interlobular septal thickening and peribronchial cuffing noted, predominantly in the lung bases. Honeycombing and fibrotic changes are also present bilaterally. There is a small left pleural effusion. Mediastinal adenopathy is present to include the pretracheal, paratracheal, AP window and subcarinal chains


Metastatic Squamous Cell Lung Cancer with Underlying Idiopathic Pulmonary Fibrosis

quiko ASQ - MedPix (2007)

There are too numerous to count multifocal nodular opacities throughout bilateral lung slices.  Diffuse interlobular septal thickening and peribronchial cuffing noted, predominantly in the lung bases.  Honeycombing and fibrotic changes are also present bilaterally.  There is a small left pleural effusion.   Mediastinal adenopathy is present to include the pretracheal, paratracheal, AP window and subcarinal chains
© Copyright Policy - open-access
Related In: Results  -  Collection

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

MPX1575_synpic39398: There are too numerous to count multifocal nodular opacities throughout bilateral lung slices. Diffuse interlobular septal thickening and peribronchial cuffing noted, predominantly in the lung bases. Honeycombing and fibrotic changes are also present bilaterally. There is a small left pleural effusion. Mediastinal adenopathy is present to include the pretracheal, paratracheal, AP window and subcarinal chains

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.