This patient was admitted through emergency department. The patient has 6 months history of respiratory tract infection. his is was followed by left sided empyema. Drainage was tried 3 times during these 6 months. complete collapse of left lung with chronic encysted empyema thoracis.
Generally, patient is underweight and cachectic.
palpable left medial axiliary lymph nodes which are firm, mobile and tender.
There was clubbing of nails (1st degree)
Chest x-ray of the chest, P-A and lateral
USS abdomen revealed a lesion of the upper pole of the kidney with poor
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The following procedures were performed:
Specimens from the left parietal pleura were sent for microscopic examination showed no growth of organisms butt no acid fast bacilli were seen.
Histo-pathological features are consistent with metastatic carcinoma.
A lesion was discovered in the upper pole of the left
kidney suggestive of primary supra-renal gland lesion. Patient was
referred to the oncologist and his advice was as followed:
" Since patient is cachectic with poor general condition, he is beyond any active treatment.
Patient's condition was discussed with the relatives. Relatives will take the patient back home with an escort.