Pulmonary
The Southwest Journal of Pulmonary and Critical Care publishes articles broadly related to pulmonary medicine including thoracic surgery, transplantation, airways disease, pediatric pulmonology, anesthesiolgy, pharmacology, nursing and more. Manuscripts may be either basic or clinical original investigations or review articles. Potential authors of review articles are encouraged to contact the editors before submission, however, unsolicited review articles will be considered.
December 2013 Pulmonary Case of the Month: Natural Progression
Robert W. Viggiano, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ
History of Present Illness
A 68 year old woman was seen for increased back pain in April 2012. In 2000 she had a right lower lobe lung resection for low grade adenocarcinoma, bronchoalveolar type, nonmucinous. Her mass was 2.6 cm in maximal dimension extending to but not invading the pleura. There were clear surgical margins but involvement of one bronchial node. Multiple mediastinal nodes were negative. She had back pain for many years and yearly CTs were negative for metastatic disease.
PMH, SH, FH
Other than the above there was no significant past medical history, social history or family history.
Medications
- Non-steroidal anti-inflammatory drugs for pain
- Nitrofurantoin for chronic urinary tract infections
Physical Examination
There was tenderness to palpation over the mid-thoracic spine and evidence of a previous thoracotomy.
Laboratory
Her complete blood count (CBC), urinanalysis, liver function tests, and calcium were all within normal limits.
Radiology
An x-ray of the chest is interpreted as unchanged from previous x-rays.
At this point which of the following radiologic testing is not indicated?
- Bone scan
- CT scan of the chest
- Magnetic resonance imaging
- Serial chest x-rays
- Thoracic PET scan
Reference as: Viggiano RW. December 2013 pulmonary case of the month: natural progression. Southwest J Pulm Crit Care. 2013;7(6): . doi: http://dx.doi.org/10.13175/swjpcc155-13 PDF
December 2013 Pulmonary Case of the Month: Natural Progression
Robert W. Viggiano, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ
History of Present Illness
A 68 year old woman was seen for increased back pain in April 2012. In 2000 she had a right lower lobe lung resection for low grade adenocarcinoma, bronchoalveolar type, nonmucinous. Her mass was 2.6 cm in maximal dimension extending to but not invading the pleura. There were clear surgical margins but involvement of one bronchial node. Multiple mediastinal nodes were negative. She had back pain for many years and yearly CTs were negative for metastatic disease.
PMH, SH, FH
Other than the above there was no significant past medical history, social history or family history.
Medications
- Non-steroidal anti-inflammatory drugs for pain
- Nitrofurantoin for chronic urinary tract infections
Physical Examination
There was tenderness to palpation over the mid-thoracic spine and evidence of a previous thoracotomy.
Laboratory
Her complete blood count (CBC), urinanalysis, liver function tests, and calcium were all within normal limits.
Radiology
An x-ray of the chest is interpreted as unchanged from previous x-rays.
At this point which of the following radiologic testing is not indicated? (click on correct answer to move to next panel)
Reference as: Viggiano RW. December 2013 pulmonary case of the month: natural progression. Southwest J Pulm Crit Care. 2013;7(6):318-27. doi: http://dx.doi.org/10.13175/swjpcc155-13 PDF