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Radiology
Case 02 - Answer
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Francis
Song, MD
A
computed tomographic (CT) scan of his chest on 12/19 showed
a right upper lobe (7x5.5x4.9) mass with multiple small
lymph nodes in the upper mediastinum. A CT-guided lung biopsy
was done and the tissue pathology showed poorly differentiated
non-small cell carcinoma, favoring adenocarcinoma. He suffered
a post-procedure right-sided pneumothorax. A chest tube
was placed with subsequent resolution of the pneumothorax.
In
the second film, a condensed line is above the mass. The
upper part of the lung is dark and without lung markings
and the right hemidiaphragm is slightly elevated all indicative
of the pneumothorax. There are some chronic fibrotic changes
seen in both lung fields.
Subsequent
to the diagnosis he was noted to have metastases to the
brain. He underwent radiation as well as three cycles of
chemotherapy. Without any improvement a decision was made
to place him in hospice care and he expired eight months
after the initial diagnosis.
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