alexa A Very Rare Case of Malignant Pleural Effusion Caused by Esophageal Cancer | Open Access Journals
ISSN: 2161-105X
Journal of Pulmonary & Respiratory Medicine
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A Very Rare Case of Malignant Pleural Effusion Caused by Esophageal Cancer

Jan Bronnert1*, Michael Respondek2 and Matthias Grade3

1Division of Pneumology,Christliches Krankenhaus Quakenbrück, Quakenbrück, Germany

2Practice for Pathology, Vechta, Germany

3Division of Gastroenterology, General Internal Medicine and Infectious diseases, Christliches Krankenhaus Quakenbrück, Quakenbrück, Germany

*Corresponding Author:
Jan Bronnert
Christliches Krankenhaus Quakenbrück
Danziger Straße 249610 Quakenbrück
Tel: 05431152842 (Sekretariat)
Fax: 05431152843
Email: [email protected]

Received date: May 09, 2017; Accepted date: May 09, 2017; Published date: May 14, 2017

Citation: Bronnert J, Respondek M, Grade M (2017) A Very Rare Case of Malignant Pleural Effusion Caused by Esophageal Cancer. J Pulm Respir Med 7:406. doi: 10.4172/2161-105X.1000406

Copyright: © 2017 Bronnert J, et al. 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.

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Case Blog

An 82-year-old man was admitted to our hospital from a geriatric clinic because of recurrent pleural effusion. Physical examination showed the patient was afebrile and haemodynamically stable with no evidence of acute respiratory distress. Laboratory investigations indicated a mild anemia with 11.4 g/dl (13 g/dl to 18 g/dl). CRP was slightly raised with 13.7 mg/l (<5 mg/l) so was sodium with 146 mmol/l (136 mmol/l to 145 mmol/l and potassium with 4.8 mmol/l (3.4 mmol/l to 4.5 mmol/l). Chest X-ray revealed a right lung pleural effusion, pleural aspiration showed an exsudate with elevated LDH of 580 U/l (0 U/l to 100 U/l). The diagnostic thoracoscopy confirmed the diagnosis of a malignant effusion and a pleurodesis was performed after obtaining multiple biopsies from the inner chest wall and diaphragm. Histology revealed a squamous cell carcinoma. Because of unknown primary we carried out a gastroscopy, where a malignant tumor was found in the upper part of the esophagus as the cause of the pleural effusion corresponding to the prior obtained histological results (Figure 1).

pulmonary-respiratory-right-pleural-effusion

Figure 1: A: Chest X-ray shows a right pleural effusion; B: Medical thoracoscopy via semiflexible pleuroscope. After complete removal of the pleural fluid, a systematic exploration of the chest revealed fibrous bands (likely caused by multiple prior needle aspiration) and malignant nodules on the diaphragm; C: Endoscopic view on the esophageal ulcerated and bleeding tumor after taking biopsies; D: H&E shows squamous cell carcinoma of the oesophagus. Note the presence of keratin formation, characteristic of well-differentiated tumor.

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