1 / 26

THORACIC CLUB MEETING AHMADU BELLO UNIVERSITY TEACHING HOSPITAL,ZARIA,NIGERIA

THORACIC CLUB MEETING AHMADU BELLO UNIVERSITY TEACHING HOSPITAL,ZARIA,NIGERIA. PLEURAL TUMORS. Case presentation Introduction Epidemiology Classification Aetiology Clinical presentation Investigation treatment conclusion. CASE PRESENTATION. A. R. 55yr, H/Wife.

howe
Download Presentation

THORACIC CLUB MEETING AHMADU BELLO UNIVERSITY TEACHING HOSPITAL,ZARIA,NIGERIA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. THORACIC CLUB MEETINGAHMADU BELLO UNIVERSITY TEACHING HOSPITAL,ZARIA,NIGERIA PLEURAL TUMORS

  2. Case presentation • Introduction • Epidemiology • Classification • Aetiology • Clinical presentation • Investigation • treatment • conclusion

  3. CASE PRESENTATION • A. R. • 55yr, H/Wife. • Refered Yusuf Dantsoho Hospital. • PC-Cough x5/12 • -Haemoptysis x5/12 • -Dyspnoea x5/12 • -Lt Chest pain x4/12

  4. Cough-distressing, non paroxysmal, • mucoid sputum, • -not posture related • Associated with – • - haemoptysis 50ml/day • -low grade fever, night sweat. • -no weight loss, contact with PTB pt. • -Lt chest pain • Dyspnoea-progressive .

  5. No history of exposure to Asbestosis, irradiation. • Does not smoke cigarret. • No FHx . • Other systemic review not contributory.

  6. PMHx- admitted 2ce, chest tube. -anti TB for 3/12 • Not a known Hypertensive, Diabetic. FSHx

  7. General physical examination. • Chest-RR-20/min SPO2 97% • -Chest tube insitu Rt 5ICS • -Deviated trachea Rt • -decreased Lt chest expansion, tactile fremitus • -dull Lt PN,decreased BS. • Other Systemic Review-

  8. Assessment-Lt haemorrhagic pleural Effusion due to -PTB • -mesothelioma • -Bronchogenic Ca

  9. Available Investigation results • CXR-

  10. Sputum AFB- -ve • Pleural fluid. • Pleural biopsy. • Abdominal USS. • ESR-60mm/hr • Pcv-36%. • WBC-9x10 N-60% L-34% M-6%.

  11. LITERATURE REVIEW PLEURAL TUMORS

  12. INTRODUCTION • Most common primary tumor of Pleura are benign and malignant Mesothelioma. • Mesothelioma are malignancy of mesothelia cells lining pleural cavity. • Often present as malignant effusion. • Less common are sarcoma, lymphoma, etc. • Virtually all cancers metastasize to pleura. • Asbestos exposure implicative.

  13. Epidemiology • 2500-3000 cases /day. (US) • 0.1-0.2 /100,000 population. • 3-4 cases /yr in ABUTH • 2-10 folds in Asbestos polluted area. • Race-no predilection. • Sex- M:F 3:1 • Age-5-7 decade. • -20-40yr post exposure.

  14. Classification of Pleural tumors • Primary tumors. • Metastatic.

  15. Mesothelioma-Benign localised M. -Malignant localised M. -Malignant epithelial M.

  16. AETIOLOGY • Asbestos- amphibole, crocidolite • Erionite. • Radiation, thorium dioxide. • Loss of one copy of chromosome 22. • SV40 Virus

  17. Clinical features • Asymptomatic. • Cough. • Chest pain.(50-90%) • Dyspnoea. • Haemptysis. • +/- weight loss. • Exposure to Asbestos.

  18. Fever, night sweat, Hyperglycemia. • Metastatic disease uncommon at presentation.

  19. Physical Examinaton. • Chest-Pleural effusion. • Systemic examination –primary site.

  20. Investigations • Diagnostic Imaging studies- • CXR • CT scan • Ultra sonography – abdomino-pelvic.

  21. VATs and biopsy. • Pleural fluid-typically not diagnostic. • Pleural biopsy-diagnostic in 98%. • immunohistochemistry.

  22. Lung function test. • Ancillary investigation. Staging TNM Brigham-

  23. Stage I - Completely resected within the capsule of the parietal pleura without adenopathy (ie, ipsilateral pleura, lung, pericardium, diaphragm, or chest wall disease limited to previous biopsy sites) • Stage II - All stage I characteristics, with positive resection margins, intrapleural adenopathy, or a combination • Stage III - Local extension of disease into the chest wall or mediastinum, into the heart, through the diaphragm or peritoneum, or extrapleurally to involve the lymph nodes • Stage IV - Distant metastatic disease

  24. TREATMENT • Surgery-Extrapleural pneumonectomy. -Decortication. Radiotherapy. Chemotherapy. Trimodality. Prognosis

  25. Conclusion Pleural tumors are rare and patients present late due to late diagnosis and referal from peripheral Hospitals, therefore overall prognosis is poor.

More Related