Patient is 29 year old Indian gentleman. He had a history of RTA with blunt trauma to the chest
He was brought to A/E with difficulty in breathing.
Plain x-ray chest showed (for x-ray click here) -
massive left sided pleural effusion with mediastinal shift to the right side.
Procedure: Drainage of pleural fluid was performed. Post drainage chest x-ray
Cytology study: Few suspicious cells
CT scan chest: Thickened left pleura especially at the lower cuts. Image 1, 2, 3, 4
Biopsy: taken from pleura lower cuts.
Histopathology: Metastatic papillary carcinoma of the thyroid to the left parietal pleura
USS Thyroid: a nodule 3 mm in the right lobe and 3 nodules -each 1 mm in diameter- in the right lobe of the thyroid.
image 1, image 2, Image 3
Clinical Re-examination of the neck: for lymph nodes revealed lymphadenopthy of the upper and lower deep cervical groups. They were enlarged moderate in size, not tender and more on the left side.
Referral : Patient was referred to radiotherapist for radioactive iodine therapy.