An 80-Year-Old Woman With Progressive Shortness of Breath and a Mediastinal Mass

Chest. 2016 Jul;150(1):e19-22. doi: 10.1016/j.chest.2016.01.025.

Abstract

An 80-year-old woman from Iran presented to our institution for evaluation of insidious onset of dyspnea and progressive hypoxemia. She had a history of hypertension, COPD attributed to secondhand smoke, and an unprovoked pulmonary embolus that was treated with lifelong anticoagulation. In addition, she had a history of latent TB status posttreatment with isoniazid 10 years prior. One year ago, home oxygen therapy was started at 4 L/min via nasal cannula, and because of her decline, her son had brought her to the United States 3 months earlier for medical help. After a contrast-enhanced thoracic CT scan followed by a nondiagnostic thoracentesis, another hospital informed her that she likely had inoperable lung cancer. She presented to our institution for a second opinion.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use*
  • Diagnosis, Differential
  • Dyspnea / diagnosis*
  • Dyspnea / etiology
  • Dyspnea / physiopathology
  • Female
  • Fibrosis
  • Humans
  • Hypoxia / etiology
  • Mediastinitis* / complications
  • Mediastinitis* / microbiology
  • Mediastinitis* / pathology
  • Mediastinitis* / physiopathology
  • Mycobacterium tuberculosis / isolation & purification
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Tuberculosis / complications*
  • Tuberculosis / diagnosis

Substances

  • Antitubercular Agents