Esophagopleural fistula and bronchopleural fistulas from lung cancer
Presentation
Known right lung cancer.
Patient Data
Right lung hilar mass 5.0 cm with invasion to the mediastinum Lymphadenopathy including right upper paratracheal, subcarinal and subclavian lymph nodes. Right adrenal mass.
3 weeks later
Formation of a huge cavity in the upper lobe of the right lung (10 cm). There is a connection between the pleural cavity and the right main bronchus reflecting a bronchopleural fistula.
There is also a connection between the pleural cavity and the middle part of the esophagus reflecting an esophagopleural fistula.
The pleura is included in this process, leading to an apical pneumothorax.
Ground glass opacity with a tree-in-bud pattern and consolidation consistent with aspiration pneumonia.
Case Discussion
A right hilar lung cancer has rapidly formed a large cavity in 3 weeks with bronchopleural and esophagopleural fistulas.
Esophagopleural fistulas are uncommon and are a type of respiratory-gastrointestinal tract fistula. They are usually associated with neoplastic lesions (primary lung or esophageal cancer). They are a life-threatening complications and have poor prognosis.