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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Collapsed Lung With Drainage Of Fluid

My cousin is hospitalized due to a collapsed lung that has not reinflated with the drainage of the fluid. They have done a talc pleurodesis procedure that failed. She has heart damage due to previous radiation tx associated with breast cancer 10 years ago. She has had a bronchoscopy with results pending. Why is the lung not reinflating? And would you feel that lung cancer may a pending dx? Would she be discharged at some point without getting the lung reinflated on supportive measures? I wish I could provide more info but I am not the one with POT.
Mon, 17 Nov 2014
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Pulmonologist,  's  Response
Thanks for your question on HCM.
In my opinion there few causes for non expanding lung in breast cancer patients.
1. Malignant bronchopleural fistula (BPF)
2. Thick fibrous adhesions which prevent lung expansion.
3. Chronic infection of pleura causes pleural thickening and this can prevent lung expansion.
So better to consult thoracic surgeon and get done repeat CT thorax. Thoracoscopic technique called VATS (Video Assisted Thoracoscopic Surgery) can be useful in this case. In this technique pleural cavity is seen under vision and if BPF is present than we can seal the fistula, if thick adhesions are there we can break the adhesion. More over pleural biopsy can also be taken for diagnosis and rule out pleural metastases.
So consult thoracic surgeon and discuss all these.
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Suggest Treatment For Collapsed Lung With Drainage Of Fluid

Thanks for your question on HCM. In my opinion there few causes for non expanding lung in breast cancer patients. 1. Malignant bronchopleural fistula (BPF) 2. Thick fibrous adhesions which prevent lung expansion. 3. Chronic infection of pleura causes pleural thickening and this can prevent lung expansion. So better to consult thoracic surgeon and get done repeat CT thorax. Thoracoscopic technique called VATS (Video Assisted Thoracoscopic Surgery) can be useful in this case. In this technique pleural cavity is seen under vision and if BPF is present than we can seal the fistula, if thick adhesions are there we can break the adhesion. More over pleural biopsy can also be taken for diagnosis and rule out pleural metastases. So consult thoracic surgeon and discuss all these.