a young female , diagnosed as having koch's due to lesions in lungs mimmicking those of koch's,on akt, presented to us with a right breast lump [ 1 month history] of around 6x6cm size, nodulated with variegated consistancy , simple mastectomy done . H.P s/o malignant phylloides. now, should we consider the lesions in chest as metastasis of sarcoma. what should be the further line of Ix and Mx . should we go for BAL trans thoracic biopsy ?
It is important that the lesions in the lungs be biopsied since if these are metastases from the phylloides tumor, it is still possible to remove these surgically and eventually improve survival (if the lesions in the lungs are less than 16 in number). This can be done with percutaneous, CT guided biopsy. I'm not sure if BAL will yield a good result since sarcoma cells are very hard to diagnose from washings.
It is also important to prove that this is not a Koch's infection, since if you give chemotherapy to this patient and the lung lesions are Koch's, then the chemotherapy may cause a flare or spread of the Koch's infection and cause further clinical deterioration.
Copyright 1994-2016MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.