A 87-year-old woman was admitted to our hospital with a history of increased dyspnoe. On physical examination the patient was distressed with an elevated respiratory rate of 28 breaths / min. Chest X-ray demonstrated an extensive left pleural effusion (A). Her arterial blood gas showed a paO2 of 7,11 kPa and a paCO2 of 4,81 kPa. Further laboratory investigations showed no other abnormalities. Pleural aspiration showed an exsudate with elevated LDH of 163 U/L (0-100 U/l). The diagnostic thoracoscopy confirmed the diagnosis of a malignant effusion and metastases on the pleura visceralis and parietalis (C) and a pleurodesis was performed after obtaining multiple biopsies. Immunhistochemical staining revealed a metastatic carcinoma of the breast to the pleura with estrogen receptor positivity in the islands of tumor cells (D). Six weeks later a follow up chest X-ray demonstrated the successful procedure of pleurodesis with talcum (B).
Figure 1. Massive effusion of the left lung with shift of the trachea to the right side.
Figure 2. Metastases on the visceral and parietal tissue.
Figure 3. Estrogen receptor positivity in the islands
Figure 4. Six weeks later after pleurodesis
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Publication history
Received: August 03, 2018
Accepted: August 16, 2018
Published: August 20, 2018
Copyright
©2018 Bronnert J. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation
Bronnert J, Respondek M and Grade M (2018Pleural effusion as a first manifestation of breast cancer. Lung Breath J. 2: DOI: 10.15761/LBJ.1000130
Corresponding author
J. Bronnert
Department of Pneumology and Infectious Diseases, Christliches Krankenhaus Quakenbruck, Quakenbruck, Germany.
Figure 1. Massive effusion of the left lung with shift of the trachea to the right side.
Figure 2. Metastases on the visceral and parietal tissue.
Figure 3. Estrogen receptor positivity in the islands
Figure 4. Six weeks later after pleurodesis
