Oesophagopleural fistula and bronchopleural fistulas from lung cancer

Case contributed by Levon Davtyan
Diagnosis almost certain

Presentation

Known right lung cancer.

Patient Data

Age: 70 years
Gender: Male
This study is a stack
Axial lung
window
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal
lung window
This study is a stack
Coronal C+ portal
venous phase
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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.

This study is a stack
Axial lung
window
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal
lung window
This study is a stack
Coronal C+ portal
venous phase
Show annotations
Download
Info

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 oesophagus reflecting an oesophagopleural 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 oesophagopleural fistulas.

Oesophagopleural fistulas are uncommon and are a type of respiratory-gastrointestinal tract fistula. They are usually associated with neoplastic lesions (primary lung or oesophageal cancer).  They are a life-threatening complications and have poor prognosis. 

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