CXR Case 084

A 61 year old lady is sent in by her GP with a fever and dyspnoea

CXR CASE 084 CXR LITFL

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).


CLINICAL CORRELATION

This lady has breast cancer with pulmonary and pleural metastases and is receiving chemotherapy.


CLINICAL PEARLS

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.


TOP 150 CXR SERIES



Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar |

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