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Cousin Billy
Your job for this assignment
is an important one. You have a relative (Cousin Billy) who has
just been You tell them the bad news, your relative has Cancer, its the bad kind and there are limited treatment options. You also decide not to give up. You are going to search the www for new treatments, currently in clinical trials, and enroll your relative in one of those trials. It is his only hope for a cure.
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to
the Doctor. He even brought back the report (below). Since you
have been to college (and have had Biology 113) all the relatives
immmediately turn to you for help. "What
does this mean?" "What
are we going to do?"
What
you need to turn in:| Cousin Billy |
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Presentation - 45 year old male with new onset nausea. History of moderate smoking Imaging
results -A
small accumulation of pleural fluid is visible on the left. MRI
images were obtained to narrow the differential diagnosis. Sagittal
images demonstrate the solid nature of the masses, which are slightly
inhomogeneous and have an intermediate signal intensity on both
sequences (arrows). The masses are well separated from Preliminary Diagnosis - The imaging characteristics of this solid mass appear to represent a tumor originating from the pleura, or from the peripheral lung. Cystic lesions, such as pericardial cyst, loculated pleural effusion, mesothelial cyst, and hematoma, as well as organized empyema, can be excluded. Solid tumors of pleural origin can be either benign, such as a fibrous tumor of the pleura, mesenchymal tumors such as fibroma, neurofibroma, neurinoma or schwannoma, and leiomyoma, or malignant, including rare conditions like pleural osteosarcoma or pleural squamous cell carcinoma. The presence of the same types of connective tissue structures in both the pleura and the lung parenchyma may give rise to the same spectrum of tumors. Primary lymphoma involving pericardial lymph node can also be considered. MRI excludes subpleural lipoma due to the absence of a fat signal within the mass. Multiple lesions of this size, with other pleural masses, make malignant mesothelioma likely, as well as pleural seeding of metastases (melanoma, breast, or lymphoma). Diagnosis - Metastatic small cell lung carcinoma ; malignant mesenchymal spindle cell tumor most consistent with differentiation of either pleural or lung origin. His chance of surviving more than one year is small. Discussion - Incidental finding of a pleural-based, solid, slightly heterogeneous enhancing mass, in association with pleural effusion, warrants a biopsy for fear of malignancy. Radiographic features of this mass do not allow further characterization, other than to exclude the possibility of various benign processes, such as lipoma, pericardial cyst, or loculated fluid collection. The smooth lateral margin of this lesion favors lung parenchymal, as opposed to a a pleural, origin. This type of Cancer is very difficult to treat. Treatment - Its up to you |
myocardium
but inseparable from pleura. There is evidence of increased pericardial
fluid, which may suggest the presence of degradation blood products.
The obtuse angles between the masses and cardiac contour in the
axial plane suggest a pleural origin. A Lung parenchymal abnormality
extending to the pleural surface is another possibility. The cardiomediastinal
silhouette is otherwise unremarkable, and the lungs are otherwise
clear. Delineation of the mass is relatively sharp, after gadolinium
injection the T1-weighted sagittal image shows certain inhomogeneity
of otherwise bright enhancement. The presence of pleural effusion,
along with the suggestion of blood products, is a
worrisome finding that denotes the
possibly aggressive nature of these lesions. After you do the research - Here is the form page, put your assignment in the form.
Here are some Resources for you (these are also on the first page of this section).
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Resources from the National Cancer Institute Deciding whether to participate Other Cancer Resources |
Biotechnology 