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Suffering From Chest Pain, Breathing Problem. X-ray, CT Scan Done. Suggested For Biopsy. Thoughts?

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Posted on Mon, 13 May 2013
Question: My father aged 68 years suffering from chest pain and some breathing problem and got admitted in Hospital in last week. After chest x-ray, in the right lungs, pleural fluid found which has been drained out and pathologically tested for fby and malignancy. But no fby or malignant cell found. Subsequently, city scan done but also the ct scan report is o.k. Now. Doctors advised for further biopsy test. Presently, my father feeling well and already taken endclav dt 650 twice a day for last 10 days.
My question - Whether the biopsy test is required or not as fluid test done which is not malignant. No tb cells were also found. Even ct scn report is not adverse. As such, what is the reason for fluid deposition and what should be the current treatment ?
doctor
Answered by Dr. Akhilesh Dubey (1 hour later)
Hi,
Thanks for posting query,

Your father is 68 years and having Pleural effusion which was tested and negative for TB and Malignancy, Please upload after scanning these reports.

Pleural fluid R&M and cytology, is there report ADA (Adenosine deaminase) in pleural fluid.
He is presently taking antibiotics for last 10 days it is good he is feeling better. It is good that he is responding to treatment.

His CT scan chest did not reveal any mass or pathology, hence it is important to take biopsy, it is not clear biopsy from where is it Pleural biopsy or Lung biopsy?
Please let me also know is he a smoker?

It is important that biopsy is done so that we do not miss anything.

In the meantime continue antibiotics and treatment as advised by Physician.
Hope this information helps, please furnish above information so that I can clarify better.

Regards.
Dr. A. Dubey M.D.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Akhilesh Dubey (29 minutes later)
Sir, thanks for reply. Further, about my father I would like to inform you that my father was smoker before 7 years back having limited smoking.

Now, Doctors advised for lung biopsy. Pleural fluid already tested for malignancy and TB, both reports are negetive.

One more important thing is that, before 7 years, gum cancer was detected and surgical operation was done and 30 rays were taken on upper maxilary right side. Since then my father is o.k.
Presently my father is not taking any antibiotic medicine except pressure tablets.

doctor
Answered by Dr. Akhilesh Dubey (2 hours later)
Hi,
Thanks for your follow up,

He has a history of smoking and a history of gum malignancy which was surgically removed and radiotherapy was given.

In view of above history it becomes necessary to go for lung biopsy in my view also biopsy should be done and future action depends on result of histopathology.

If he is taking any treatment for High BP please continue the same.
If malignancy is suspected a whole body (Positron emission tomography) PET scan may be useful, you can discuss with your treating Physician.

Hope this information helps you to take right decision, in case you have any doubt please feel free to ask, I will be available to clarify.

Regards.
Dr. A. Dubey M.D.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Akhilesh Dubey

Internal Medicine Specialist

Practicing since :1986

Answered : 2094 Questions

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Suffering From Chest Pain, Breathing Problem. X-ray, CT Scan Done. Suggested For Biopsy. Thoughts?

Hi,
Thanks for posting query,

Your father is 68 years and having Pleural effusion which was tested and negative for TB and Malignancy, Please upload after scanning these reports.

Pleural fluid R&M and cytology, is there report ADA (Adenosine deaminase) in pleural fluid.
He is presently taking antibiotics for last 10 days it is good he is feeling better. It is good that he is responding to treatment.

His CT scan chest did not reveal any mass or pathology, hence it is important to take biopsy, it is not clear biopsy from where is it Pleural biopsy or Lung biopsy?
Please let me also know is he a smoker?

It is important that biopsy is done so that we do not miss anything.

In the meantime continue antibiotics and treatment as advised by Physician.
Hope this information helps, please furnish above information so that I can clarify better.

Regards.
Dr. A. Dubey M.D.