Malignant Pericardial Effusion: Case Report and Review Article
Kerbala Journal of Medicine,
2011, Volume 4, Issue 9, Pages 1024-1032
Abstracta sixty-five year old farmer presented with dry cough & mild exertional dyspnea for 10 days, he has no previous history of asthma or TB, he was not smoker, with no history of hypertension or diabetes, O/E he is well built not cyanosed, mild dyspoenic BP 130/80, PR96/min regular, respiratory rate 20/min.chest examination is clear, Heart examination is normal, abdominal examination also normal. Chest X-Ray done for him shows normal lung field with enlarge cardiac globular shadow .He was sent for ECHO study which reveals normal cardiac chamber size& contractility with normal AV& semilunar valve. There is pericardial effusion of 21 mm depth posteriorly with early signs of tamponade. The patient was admitted to the hospital, initial hematological & biochemical investigations were normal. emergency pericardiocentesis done under ECHO & ECG monitoring where 300 CC of deep yellowish fluid aspirated and sent for laboratory study the results are protein =3.1gm/dl.sugar =43mg/dl/.microscopical examination reveals a hemorrhagic background with scattered sheets of atypical epithelial cells highly suggestive of malignant tumor most likely is squamous cell carcinoma of the lung. CT scan of the chest showed 17x19 mm enhanced lung mass at left upper lobe near the aortic arch, no hilar LN with big pericardial effusion.
After three days the patient presented with severe dyspnea & the echo showed big pericardial effusion so surgery is planned. Percardiecctomy with segmental peumonectomy done, the surgery was smooth with normal convalescence. The histopathology of the pericardium did not recognize a malignant involvement and that of the lung revealed moderately differentiated adenocarcinoma, after the healing of the wound the patient reassessed with CX-Ray &ECHO which was normal &he started a course of chemotherapy. He did well for the last 7 months
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