کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
8745847 1593193 2018 17 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Germ cell tumor causing pleural effusion: A diagnostic dilemma
ترجمه فارسی عنوان
تومور سلول های بنیادی باعث افیوژن پلورال می شود. یک معضل تشخیصی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های عفونی
چکیده انگلیسی
Straw colored pleural fluid with raised adenosine deaminase (ADA) levels in young healthy adults usually raises suspicion of tuberculosis, sometimes leading to laxity in carrying thorough physical examination and missing out some important clues with potential disastrous consequences. A 35-year-old male was diagnosed to have left pleural effusion and anti-tubercular treatment was started on the basis of straw colored, lymphocyte-predominant pleural fluid with significantly raised ADA levels. When there was no improvement after 1 month of treatment he was investigated further and found to have a mediastinal mass along with hydro-pneumothorax. Fine needle aspiration cytology (FNAC) of the mass was done twice at different centers with different reports followed by biopsy from the mass to settle the diagnosis. Histopathological examination revealed yolk sac tumor. Testicular ultrasound showed a mass with ill-defined hypoechoic areas and lobulated margins in left testis, which was missed on clinical examination. Serum lactate dehydrogenase (LDH) and alpha fetoprotein (AFP) levels were found to be elevated. Beta-human chorionic gonadotropin (β-hCG) was normal. The final diagnosis of nonseminomatous germ cell tumor with mediastinal metastasis was made. The present case underlines the importance of good clinical examination, an art which is diminishing with availability of sophisticated investigations and a thin line of difference between potentially curable and fatal diagnosis, especially in young population, where malignancy is overlooked as a differential diagnosis. Furthermore, despite all its advantages, too much reliance on FNAC may be responsible for misdiagnosis in certain cases.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Indian Journal of Tuberculosis - Volume 65, Issue 1, January 2018, Pages 80-83
نویسندگان
, , , , ,