Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pleural space disease is often complex, difficult to diagnose, and problematic to manage. At computed tomography (CT), empyema appears as an oblong fluid collection with smooth inner margins that compresses and displaces the surrounding lung and airways away from the pleural collection. CT findings in hemothorax include heterogeneous attenuation of pleural fluid, hyperattenuating areas of debris within pleural fluid, and a "fluid-hematocrit" level. Nodular pleural thickening at chest radiography or CT indicates a malignant pleural effusion; the cross-sectional capability of CT allows scrutiny of all pleural surfaces to detect enhancing tumor implants in addition to pleural effusions. Pleural plaque, rounded atelectasis, and pleural pseudotumor can mimic neoplastic disease on chest radiographs but can often be diagnosed with CT. Bronchopleural fistula may also be difficult to diagnose with radiography alone, necessitating further analysis with CT. Pleurocentesis fluid containing chyle, cerebrospinal fluid, amylase, or hyperalimentation fluid indicates pleural space disease with an unusual or iatrogenic cause. Recent advances in image-guided procedures have significantly improved treatment options for many complex pleural space processes.
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PMID:Complex disease of the pleural space: radiographic and CT evaluation. 901

A 70-year-old man with T1N3M1 stage IV squamous cell carcinoma in the right upper lobe of the lung developed chylothorax and chylopericardium as rare simultaneous complications. Intravenous hyperalimentation, repeated pleurodesis, and ligation of the thoracic duct were all ineffective. A pleuroperitoneal shunt was inserted into the right pleural cavity from the fifth intercostal space, and a peritoneal catheter was placed in the abdominal cavity. Chylothorax was markedly improved, and the quality of life of the patient increased. This case indicates that a pleuroperitoneal shunt can be used for lung cancer-related chylothorax, as well as for malignant pleural effusion.
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PMID:Pleuroperitoneal shunt for chylothorax and chylopericardium in lung cancer: a case report. 2158 32

Chylothorax occurs following dysfunction or disruption of the lymphatic drainage along the thoracic duct. Malignant and traumatic causes account for the majority of these occurrences, with lymphoma accounting for 11-37% of chylothoraces. The clinical course of chylothorax may include dehydration, malnutrition, immunosuppression, electrolyte disturbances, infection, and ultimately death. Management of chylothorax is patient-specific and is based on etiology and surgeon experience. Initially, most chyle leaks are managed with nonoperative strategies, such as gut rest, hyperalimentation, and pleural drainage, and, at times, medium-chained fatty acid diet or octreotide, with hopes to decrease chyle production (Zabeck et al. (2011)). High-output chyle leaks following iatrogenic injury or trauma are commonly managed with thoracic duct ligation. Lymphangiography with or without thoracic duct embolization has become increasingly popular and efficacious with the possible benefit of less morbidity (Cope et al. (2002)). We report a case of a 61-year-old male with delayed chylothorax while having an indwelling pleural catheter for malignant pleural effusion during treatment of follicular lymphoma. Percutaneous thoracic duct embolization was attempted but was unsuccessful. Chemotherapy, fluid management, and nutritional support allowed this to resolve over the course of ninety days from diagnosis. We describe the patient's clinical course and highlight nonoperative management of delayed chylothorax in the setting of follicular lymphoma treatment.
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PMID:Delayed Chylothorax during Treatment of Follicular Lymphoma with a Malignant Pleural Effusion. 3215 84