Background: Although lung cancer is the most common malignancy diagnosed in patients with venous thromboembolism (VTE), data regarding pulmonary embolism (PE) in lung cancer patients are limited. Objectives: To investigate the clinicoradiological features, clinical course and survival of lung cancer patients with PE. Methods: We performed a retrospective case-control study investigating the clinical course and survival of 40 lung cancer patients with PE (PE group). The control group (non-PE group) consisted of 80 lung cancer patients without VTE, treated during the same period. Results: Adenocarcinoma (45.0%, n = 18) was the most common histological type of lung cancer and when PE was diagnosed, the majority of the lung cancer patients were in stages IIIB (37.5%, n = 15) and IV (47.5%, n = 19). Thirty-four patients (85.0%) were diagnosed with PE within 12 months of the diagnosis of lung cancer. The median survival from the diagnosis of PE was 3.5 months in the PE group, but the survival rates revealed no significant difference between the two groups (p = 0.249). In both groups, the most common cause of death was lung cancer progression (76.9 and 80.3%, respectively), followed by chemotherapy-related septic shock (19.2 and 16.7%, respectively). Conclusions: In lung cancer patients, PE may not be the main cause of death, but one of the various complications of lung cancer, despite suggesting a poor prognosis.
Data regarding parapneumonic pleural effusion in Mycoplasma pneumoniae pneumonia (MP) patients are limited. In this study MP patients with pleural effusion tended to be younger and had longer hospital stays and more common use of systemic steroids compared to those without pleural effusion. In 5 of the 6 patients for whom pleural fluid data were available, the pleural effusion was lymphocyte-predominant rather than polymorphonuclear leukocyte-predominant; these patients also had elevated adenosine deaminase levels. Taken together, these results indicate that MP patients with pleural effusion may have a more severe form compared to those without pleural effusion. M. pneumoniae should be considered an aetiological agent of lymphocyte-predominant pleural effusion.
A 69-year-old male was diagnosed in February 2004 with stage IV extranodal marginal zone B cell lymphoma involving the mediastinal nodes, lung parenchyma and bone marrow with high LDH. Shortness of breath developed following the 5th course of Rituximab-CHOP chemotherapy (cyclophosphamide, Vincristine, Doxorubicin, Prednisolone). Bronchoscopy guided transbronchial lung biopsy revealed interstitial thickening and type II pneumocyte activation, compatible with interstitial pneumonitis. After treatment with prednisolone a complete resolution of the dyspnea was observed. The patient was well on routine follow-up at the outpatient clinic, with no progression of lymphoma or interstitial pneumonitis.
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