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Old 09-19-2011
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Lungs Best next step in lung mass diagnosis

60 YO man with long history of heavy smoking, presented with shortness of breath & hemoptysis. Chest X ray showed Rt pleural effusion & Rt lung mass. What is the best next step that you should do to make a diagnosis?
  1. CT scan.
  2. Bronchoscopy & lung biopsy.
  3. Cytology after effusion drainage.
  4. Mediastenoscopy.
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Cytology after effusion drainage
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Old 09-19-2011
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cytology after effusion drainage...

than CT
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Old 09-19-2011
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i think,it should be > Bronchoscopy & lung biopsy.
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Old 09-19-2011
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bronchoscopy n lung bx
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Old 09-19-2011
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Cytology after effusion drainage.
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Old 09-19-2011
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cytology after effusion drainage

you are posting nice qs ....may i know the source is it kaplan q book ?

Last edited by Ace3; 09-19-2011 at 10:03 AM.
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Old 09-19-2011
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I made up that Q, based on Kaplan videos on pulmonary system.
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Old 09-19-2011
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The correct answer is cytology after pleural effusion.
The idea behind that, it is simple, & if positive, you have get know, not only the diagnosis, but also the staging, as we know metastatic lung cancer is not for surgery.
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Old 09-19-2011
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In addition to that any new found Pleural effusion should always be investigated with thoracocentesis & analysis.

In the above case we can do cytology to look for malignant cells.

Also drainage of the pleural fluid will give symptomatic relief to the pt, by relieving dyspnea.
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