Presentation
Non-smoker presents with 2 week history of progressive shortness of breath and decreased appetite. Admitted to ICU for desaturation to the 80s on the floor.
Patient Data
Large left tension hydrothorax causing mediastinal shift to the right.
Thoracentesis removed some 2 L of translucent yellow-tan pleural fluid with no frank purulence or blood. CT of the chest with contrast was obtained immediately following tap.
Large left pleural effusion. Enlarged left hilar lymph nodes. Large 2 x 7 cm left upper lobe mass.
Case Discussion
Fluid was sent for analysis revealing exudative, lymphocyte predominant pleural fluid. Cytology consistent primary lung cancer.
The patient was discharged from the ICU after placement of pleurex chest tube as the pleural effusion continued to re-accumulate at a fast rate. She was instructed to follow-up with the oncologist who had met with the patient while in the hospital. Of note, the patient, a non-smoker, was in her usual state of health just a month prior to hospital admission. This was the first respiratory problem she had had in her life, and she left the hospital with the diagnosis of primary lung carcinoma.
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