A 61 year old lady is sent in by her GP with a fever and dyspnoea
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is a right sided pleural effusion with an ipsilateral indwelling pleural catheter.
There is a right sided hilar / upper lobe spiculated mass.
There is an infusaport in situ on the left.
Left lung field is normal.
Evidence of right sided mastectomy and axillary clearance (surgical clips).
This lady has breast cancer with pulmonary and pleural metastases and is receiving chemotherapy.
An indwelling pleural catheter (IPC) is a silicone-rubber tunneled chest drain that enables ambulatory management of malignant pleural effusions.
IPC’s are safe with chemotherapy (no increased infection risk) and even withstand local radiotherapy!
The pleural infection rate is ~5% of patients with an IPC – a sterile technique should be used to sample from an IPC or connect to drainage.