Ghulam Khaleeq

Emerging paradigms in the management of malignant pleural effusions.

Malignant pleural effusions (MPE) are a common clinical problem in patients with neoplastic disease. The development of MPEs in advanced malignancies can cause significant morbidity and mortality. Predominant symptoms of dyspnea, cough, and chest discomfort are usually debilitating. Given the poor prognosis of majority of these patients, palliation is more desirable than cure of an individual complication. Despite multiple new therapies placement of chest tube with sclerotherapy remains the standard of care. The purpose of this article is to review the emerging therapeutic options for MPE management.

A 21-Year-Old Male With Dyspnea at Rest, Dry Cough, and Swelling of His Right Anterior Chest

A 21-year-old, previously healthy, Hispanic male presented with complaints of resting dyspnea, fatigue, and a nonproductive cough. His shortness of breath was initially exertional but had progressed to resting dyspnea during the past month. The patient stated that he also experienced increasing fatigue. On questioning, he stated that during the past month he had noticed an enlarging area of fi rmness over his right anterior chest that was mildly tender to palpation. He denied fever, chills, sputum, or hemoptysis. In addition, he had not experienced weight loss, night sweats, or gastrointestinal symptoms. He did describe polyuria and was found to be hyperglycemic when he measured his glucose at home on his mother’s glucometer. The patient was a nonsmoker and denied use of alcohol or illicit drugs. He denied any exposure to toxins. He had no drug allergies nor did he use any medications. His family history was signifi cant only for type 2 diabetes. The patient was in the army reserve, having returned from active duty in Iraq 1 year prior to this presentation. A 21-Year-Old Male With Dyspnea at Rest, Dry Cough, and Swelling of His Right Anterior Chest

Clinical Features of Thymus Pathology

Thymus pathology embraces a broad spectrum of features, varying from major immunologic abnormalities affecting all organ systems to minor abnormalities with limited clinical consequences. Some individuals with thymus pathology may have all the features of the disease while others may have only a few features. In this chapter we will review clinical features of common thymus pathologies. Tables 7.1 and 7.2 list the localized and systemic symptoms due to mediastinal tumors [1].