Hypoxia and Medicine

cardiac tamponade,pleural effusion and many thrombosis ,is it mesothelioma?

My aunt is 40 years old,housewife,has 2 daughters and a son ,she had a history of intrauterine fetal death 5 years ago, her youngest child is now 2 years old,not diabetic or hypertensive, she came to internal medicine clinic for abdominal pain,pain was diffuse in abdomen ,but sharp in right hypochondrium, no refered pain to shoulder. she had nausea,vomiting.she looked very ill and pale in the same day she had chest x ray which revealed cardiomegaly and elevated right copula of the diaphragm,no pleural effusion detected. she had abdominal ultrasound that showed mild ascites,mild right pleural effusion,mildly enlarged liver with no focal lesions,mild thickened gall bladder. She did liver enzymes,amylase and were within normal. Next day she was very ill and was admitted to hospital,ICU unit,she was shocked and collapsed,80\50 blood pressure,36.5 T,tachypnea,congested neck veins,and she was given saline and ringer through central venous cannula,she had blood transfusion. Echo revealed massive pericardial effusion and tamponade. She had life saving pericardiocentesis, sample of the bloody effusion revealed atypical mesothelial cells,and no organisms was detected,further investgation revealed: -Hb 9.3 -leucocyosis -thrombcytopenia -Ast 64 -Alt 156 an window operation was recommended,but postponed for 1 day for blood, platlet trasfusion . the operation was done ,effusion was revealed,cautrey was used for some pericardial erosions,biopsy from pericardium showed; gross; muliple flattened pieces 6*6 cm with rough brownish surfaces of average thickness 0.3 cm. microscopey; sectiones showed thickened non-specific inflammation.hyperplastic mesothelium was recorded.clotted fibrin and blood were seen. Conclusion: non specific inflammation,mesothelial hyperplasis and wide fibrosis. Patient then was admitted to icu unit after operation,with ventilator,chest tube got mild bloody effusion,echo revealed mild pericardial effusion without tamponade that became markedly decreased in rate later. After 3 hours of ventilator removal,patient became dyspnic,low oxygen saturation,ventilator was used again and c.t was done and showed; Chest_ Bil pleural effusion more voluminous on right side with bil basal&left mid zonal underlying consolidation collapse.bil basal,left upper&mid zonal atelectasis&pneumonitic plates. Pericardial thickening(mesh put on operation?) Mediastinal fat blurring&increased density,mediastinitis, ant chest wall subcutaneous,soft tissue thickening&surgical emphysema. Abd&pelvis_ Mild fullness of right pelvicalyceal system&proximal part of its draining ureter. Bulky uterus? 3days after, ventilator was removed and oxygen mask used,general state became better. dopler was recommended& showed: popliteal,bil iliac,superficial femoral v thrombosis,clexane 40,and corticosteroids was given. after 2 days she had more thrombi,on subclavian and axillary vein?? Dose of clexane was increased To 60,corticosteroid also to 1 gm Investigation for auto- immune diseases systemic lupus and antiphospholipid,anticardiolipin was done and negative One day after,marked hemiparesis was noted,urgent ct brain was done to reveal: Left tempro-parietal hypodense lesion,mass effect on left frontal horn. MRI was recommended and revealed: Reactive pleural thickening,oedema involving left parietal,diaphragmatic pleura. Small left pleural sac effusion. Segmental consolidative pneumonic process in lower lobe of left lung involving the post and lat basal segments in the form of hetregenous alveolar filling and traceable air bronchogram. Right lung showed patchy consolidation. Reactive pericardium thickening,no sizeable pericardial collections. Abnormal appearance of the left chest wall in the form of anterior swelling and oedema like signal with intermuscular fat planes obliteration. Mildly enlarged liver . Right lower abdominal uretropathy . VITAL SIGNS OF PATIENT AND GENERAL CONDITION IS STABLE AND PHYSIOTHERABY HAS BEGUN,BUT SHE HAS HAEMOPYSIS,ANTIBIOTICS WAS GIVEN FOR MRSA THAT APPEARED IN NASAL SWAP,AND DOSE OF CORTICOSTEROID ARE GRADUALLY DECRASED. IS IT MESOTHELOMA? SHOULD PATIENT DO FURTHER INVESTIGATION(LAB&IMAGING)? IS POSITERON EMISSION TOMOGRAPHY(PET) NEEDED? WHAT DRUGS SHOULD WE ADD? IN OTHER WORDS WHAT IS DIAGNOSIS AND MANAGEMENT?

Public Comments

1. Your aunt is in a hospital surrounded by trained professionals with proven credentials. You have no idea who will answer you on this or any accounting for their knowledge, training, or credentials. Yahoo Answers is not going to come up with a better result. We can't know everything they know or seek out new tests to better understand the case better. If you want to seek medical opinions, find another doctor who has experience dealing with the pulmonary system or possibly an oncologist to determine if this is mesothelioma or any other disease state. This is not the place to seek out diagnosis or treatment advice. I am sorry for your aunt and the dire situation. I hope her doctors will be able to determine a proper diagnosis and she can reach a full recovery. Let the doctors be the doctors and you be the family.
2. How did you get ahold of your aunt's medical chart? Or, is this a case study for a nursing assignment?
3. Reading your Aunt's diagnosis and results, this really calls for professional medical help. It sounds like it is a medical complication that saying or concluding that it is a form of cancer (like mesothelioma) is not sound or wise.