Common cases in respiratory medicine: lung cancer
This article describes the approach to the ward round in our second patient, Mr Knight, who has lung cancer
Barry Knight is a 72 year old man with gradually worsening shortness of breath. He is an ex-smoker who had a stroke five years ago. You review his notes.
Looking at the notes, you see that the admitting team thought that Mr Knight had a pleural effusion and admitted him to the respiratory ward for further investigation.
Mr Knight underwent chest radiography on admission, which confirmed a left sided pleural effusion. The team subsequently ordered a CT scan of the thorax to help determine the cause of his effusion. This showed a 4.1×4.5 cm lung mass, multiple enlarged mediastinal lymph nodes, and bilateral pleural effusions, which were small on the right and moderately large on the left (figure). He also had a moderate pericardial effusion.