Pathophysiology of pleural effusion and

19M, US, 6’2, around 160 lbs, no tobacco or vaping/social drinkesmokes marijuana daily, neg hx except allergies/asthma (takes allegra when he remembers)
recently, my son was at urgent care (URI) and weighed in at 150. he was there about a year prior and weighed 190-something. he had not been trying to lose weight. he went to his PCP and had a bunch of bloodwork, thyroid ultrasound, and a CT of the abdomen & pelvis. everything was normal, except for the CT scan. here is the report:
EXAM: CT scan of the abdomen and pelvis with oral and intravenous contrast
History: 19-year-old. male with greater than 40 pound weight loss over 1 year. No history of surgery, smoking or malignancy. Patient reports a history of asthma.
COMPARISON: None
TECHNIQUE: CT scan of the abdomen and pelvis was performed on bolus of 85 mL of Omnipaque 350 via IV injection. Axial images along with coronal and sagittal reconstructions were performed and reviewed. There were no complications.
FINDINGS: Spleen is normal at 11,4 cm in length. Liver is at the upper limits of normal in size measuring almost 18 cm in length. No liver mass is identifled. No ascites, pleural effusion or pericardial effusion noted. No acute or focal abnormality is noted in the lung bases.
Aorta, IVC, hepatic veins enhance normally. No retroperitoneal lymphadenopathy. Kidneys are unremarkable. No adrenal mass is seen. Pancreas gallbladder and biliary tree are unremarkable as visualized.
The stomach is unremarkable. Large bowel is unremarkable. Well-defined filling defect (2 cm in AP dimension 5.4 cm in length) is noted in the lumen of the left jejunum on coronal image 30 and axial image 72 series 2. Otherwise small bowel is unremarkable. Appendix is not visualized. No mesenteric lymphadenopathy seen.
No anterior abdominal wall hernia is noted. Left colon is collapsed. No lymphadenopathy or mass seen in the pelvis. Prostate, bladder and seminal vesicles are normal. No hernia or lymphadenopathy seen in the groin.
Review of the osseous structures was performed and no mass or destructive process is noted.
IMPRESSION:

1. Focal filling defect and possible mass in the left jejunum as above. Further clinical follow-up is recommended.

Results and recommendations for follow-up were telephoned to the referring practioner’s office.
his PCP wants him to see a general surgeon this week, and has already spoken to two of them, so we should have an appt day & time on mon. my son and i currently live in different states, but i will be traveling to attend the appt with him. in the meantime, i am trying not to fall apart.
my son does not know his whole family history - both his maternal and paternal grandfathers were adopted. however, there is a history of GI cancer on both my maternal and paternal sides of the family. 😭 (tho not at such a young age - 50s and up)
any insight would be much appreciated, whether it be good, bad or ugly. is it likely that this could this be cancer? could this be something that he was born with? he has no pain, nausea, no GI symptoms at all, and whatever this thing is isn’t palpable.
thank you for any insight and/or advice!

As the title states, she was so much more than a pet to me. She was my soul cat and her death has absolutely wrecked me. She was diagnosed with CHF last October and we’ve spent the last 6 months fighting it. Shes had a couple scares, namely a pretty severe sudden pleural effusion episode that left her hospitalized after a vet visit that freaked her out. But when she’s at home, you wouldn’t know she was sick. I know cats hide illness very well, but from my eyes, she was doing very well on her meds.
She was scheduled for a routine recheck with an echocardiogram, and she was given sedatives since her last experience went south. She took them well and seemed very relaxed and out of it in the car ride there. The vet tech took her upstairs while I spoke to another tech about how she’s been since her last visit. Then within minutes, the first tech comes sprinting back down the stairs telling me she’s being rushed to the emergency department next door. I follow her in a fog and get briefed rather quickly that she suffered a severe plural effusion almost as soon as she was taken from the carrier. I went back and forth with her specialist for 20 minutes before I was called back by the emergency cardiologist, telling me that she wasn’t looking good.
What I saw is hard to put into words. My baby was lying in an oxygen chamber, completely unable to lift her head, chest heaving with breath she couldn’t catch, eyes wide and utterly terrified. Without getting into too many details, it was decided that the most humane thing to do was to put her down right there in the bright emergency room after I was only able to hold her for a few seconds (I didn’t want her to suffer without the oxygen). She died in fear and pain, and I cannot forgive myself for that.
She deserved so much better than that. I’d planned for so much better than that. What I’m struggling with is my own naivety. I was told she would likely only get 6 months, but she seemed to be doing well so I went into complete denial. I also have a young toddler so distraction is at an all time high. I thought she would be the one to beat the odds. Looking back I can see how thin she’d gotten despite eating well, how I should have been checking her breath count more often, especially before I handed her off to the vet. If I had, maybe she could have passed peacefully in my arms, instead of gasping and drowning in her own fluid. Maybe I would have seen that she was stressed and not just loopy from the sedative as I thought. Maybe I should have demanded they let me take her to a private room with an oxygen tank in tow so she could have at least passed with me holding her instead of lying in a bright and scary place with me over her. Just so many what if’s that I fear will never leave me.
Her life was beautiful, she lived a happy 13 years, but the ending was so terrible that I can’t help but imagine what she must have thought in her final moments. The betrayal she must have felt for me being the one to bring her there.
I don’t know what to do with these thoughts and this pain. I want out of my own mind.

Yesterday my wife found out she has Pleural Effusion with Mesothelioma. My readings on it show it is pretty close to being terminal with anywhere from 4-18 months from initial diagnosis. Anyone else have it and what where the basic treatment options? There are fairly respectable papers out on "starving" the cells of glucose and using some specific supplements on assisting chemo (Resveratrol - the stuff in and grapes) which is shown to reduce growth rates. I don't think she comprehends the outcome just yet and while we are setting up the initial appointments for Pulmonoligists and Oncologists, I think she is operating as it is no big deal. I feel this is her way of accepting it as part of life and if so, pretty awesome in my book.

Female, 36yo, 171cm, 57kg, Caucasian
Medications: propranolol since march 2022 for migraine prevention, Depo provera since September 2023
Location: Poland (I use private healthcare whenever possible, but for certain diagnostics or treatments using public healthcare is the only option)
Ten years ago my partner was treated for active TB, but I have never shown symptoms of TB disease.
Last summer I developed a small cough and occasional wheezing. It didn't go away by autumn so I did a chest X-ray and went to a pulmonologist. They said my symptoms sound like asthma (I did have an inhaler prescribed in childhood) but the X-ray showed changes in my upper lungs so they ordered a HRCT for a better view. The results (translated):
"CT chest without contrast. In the apical and posterior segments of the upper lobes, there are markedly fibrous-nodular calcified changes with minimal bronchiectasis. The largest of the tuberculomas is approximately 13 mm in segment 1/2L. Besides this, the lungs show no consolidations or interstitial changes. The trachea, main bronchi, lobar, and segmental bronchi show no focal narrowing. Mediastinal, hilar, and axillary lymph nodes are not enlarged. The thoracic aorta is of normal size. The pleural cavities show no effusion. The adrenal glands are not enlarged. In the thoracic spine, there are signs of a previous Scheuermann's disease."
The doctor said my lungs look like I did have TB infection in the past but that the calcifications and lack of symptoms indicate my body handled the infection quietly on its own. Nevertheless they wanted me to do sputum cultures for TB, just in case, to rule out active TB before doing a work up for asthma.
So I did the tests- sputum smear, general culture, and 3 TB cultures. Everything came back negative for TB.
Also during this time I quit smoking cigarettes (pack a day habit for 20 years) and the cough I previously had went away completely.
The pulmonologist said that my cultures are negative and I have no symptoms of TB, so the crappy image of my lungs must be the remnants of previous TB infection. They said I don't need treatment and we can move on to an asthma work up.
However, a couple months later, they called me and told me that they have been thinking about my case and are referring me to the local TB hospital for them to make the final decision of what to do with me, i.e. if I should have further testing.
The hospital wants to admit me for a week to do a bronchoscopy. They scheduled me to come in on Monday.
My problem with this is that they want to put me in a ward with suspected active TB patients where it is 8 people to a room!
So this brings me to my question: Am I justified in thinking that it's a terrible idea for me to spend a week in a cramped room with 7 likely active TB patients when I show no signs of active TB?
I'm afraid that I will get (re?)infected with fresh TB or some other mycobacterium! Or god knows what else... I am really stressing out about this, I am terrified for my safety. I don't know if I should fight the hospital about their plans for putting me in a room with active TB patients or not. What do I do? Am I overthinking this?

Male/27/280lbs
Non smoker Non drinker I chew smokeless tobacco
About 5 months in to strictly Whole Foods and constant exercise down from 350lbs over the span of a year on and off dieting and exercise I am down 40 pounds in the last 5 months
I have spent the last 10 years of my life surviving on fast food alone. That’s how I went from in great shape 185 lbs to an anxious 350lb ball
LONG HISTORY OF HEALTH ANXIETY
I have had EKG’s, 1 echo, blood work of just about everything. All normal.
Within the last couple years my lipids were as follows
2021 Total Cholesterol/Triglycerides/LDL/HDL mg/dL 161/245/83/30
2023 Total Cholesterol/Triglycerides/LDL/HDL mg/dL 191/216/114/35
2024 Total Cholesterol/Triglycerides/LDL/HDL mg/dL 161/103/111/29
Today I went to the ER for the 3rd time since Sunday for racing heart, numbing in face feet and hands, difficulty breathing, pain in left arm. You name it. They always ask me what might be stressing me out at home and this time I finally said I think I’m stressing that I have plaque build up and it’s causing these symptoms. He told me he can’t give me a Coronary CT or CT calcium score in the emergency room but he can give me a CT angiogram of my head neck and lungs and tell me if he sees plaque where I’m concerned about. He was by far my favorite doctor but I’m worried that he hid some stuff from me to protect me for the next couple days since he knew I wasn’t in immediate danger and recommended I follow up with a cardiologist despite saying “everything looked awesome” the reason this doubt arose in my head was because they found two pleural effusions and a benign growth. Which to me is definitely less than awesome. Can anyone here help me chill out? I saw my primary this morning and she upped my lexapro and recommended therapy so I have seen a doctor.
My family history.
My paternal Grandma beat lung cancer in her 80’s and is still going strong.
Paternal Grandpa was an overweight diabetic who had strokes that didn’t seem to bother him at all. Died in his late 80’s seemingly of old age.
My dad has an aortic aneurysm and never goes to the doctor or takes medicine and he’s in his 60’s and has smoked all his life.
My mom is a 60 year old asthmatic with copd and smoked all her life.
Maternal Grandpa unknown
Maternal Grandma died of lung cancer before I was born
Sorry for the lengthy introduction but I’m desperate. Once you hop on to the mental health train around here, it’s hard for symptoms to be taken serious. Problem is, I understand why. I just can’t accept it. I want peace of mind. So please anyone who can. Help me

Male/27/280lbs
Non smoker Non drinker I chew smokeless tobacco
About 5 months in to strictly Whole Foods and constant exercise down from 350lbs over the span of a year on and off dieting and exercise I am down 40 pounds in the last 5 months
I have spent the last 10 years of my life surviving on fast food alone. That’s how I went from in great shape 185 lbs to an anxious 350lb ball
LONG HISTORY OF HEALTH ANXIETY
I have had EKG’s, 1 echo, blood work of just about everything. All normal.
Within the last couple years my lipids were as follows
2021 Total Cholesterol/Triglycerides/LDL/HDL mg/dL 161/245/83/30
2023 Total Cholesterol/Triglycerides/LDL/HDL mg/dL 191/216/114/35
2024 Total Cholesterol/Triglycerides/LDL/HDL mg/dL 161/103/111/29
Today I went to the ER for the 3rd time since Sunday for racing heart, numbing in face feet and hands, difficulty breathing, pain in left arm. You name it. They always ask me what might be stressing me out at home and this time I finally said I think I’m stressing that I have plaque build up and it’s causing these symptoms. He told me he can’t give me a Coronary CT or CT calcium score in the emergency room but he can give me a CT angiogram of my head neck and lungs and tell me if he sees plaque where I’m concerned about. He was by far my favorite doctor but I’m worried that he hid some stuff from me to protect me for the next couple days since he knew I wasn’t in immediate danger and recommended I follow up with a cardiologist despite saying “everything looked awesome” the reason this doubt arose in my head was because they found two pleural effusions and a benign growth. Which to me is definitely less than awesome. Can anyone here help me chill out? I saw my primary this morning and she upped my lexapro and recommended therapy so I have seen a doctor.
My family history.
My paternal Grandma beat lung cancer in her 80’s and is still going strong.
Paternal Grandpa was an overweight diabetic who had strokes that didn’t seem to bother him at all. Died in his late 80’s seemingly of old age.
My dad has an aortic aneurysm and never goes to the doctor or takes medicine and he’s in his 60’s and has smoked all his life.
My mom is a 60 year old asthmatic with copd and smoked all her life.
Maternal Grandpa unknown
Maternal Grandma died of lung cancer before I was born
Sorry for the lengthy introduction but I’m desperate. Once you hop on to the mental health train around here, it’s hard for symptoms to be taken serious. Problem is, I understand why. I just can’t accept it. I want peace of mind. So please anyone who can. Help me

Hi Doctors,
Should I worry about the result of my Chest CT scan?
Result below:
CT SCAN OF THE CHEST Contrast-enhanced axial and coronal CT images of the chest were obtained. Lungs: There is a 1.4 x 1.7 x 1.5 cm (CC x T x AP) calcified nodule in the superior segment of the left lower lobe. A 0.5 cm calcified nodule in is seen in the superior segment of the right lower lobe. There are linear densities in the left lower lobe. There are no evident active inflammatory opacities. Pleura: No pleural thickening or effusion. Mediastinal and hilar lymph nodes: Unenlarged. Heart: Normal in size. Pericardium: No pericardial effusion or thickening. Vascular structures: Unremarkable. Osseous structures: There are minimal hypertrophic changes in the thoracie spine. Focal sclerosis is seen in LI vertebral body. IMPRESSION: CALCIFIED GRANULOMAS, BOTH LOWER LOBES FIBROSIS/SUBSEGMENTAL ATELECTASIS, LEFT LOWER LOBE NO EVIDENT ACTIVE INFLAMMATORY OPACITIES AT THE TIME OF EXAMINATION MINIMAL THORACIC SPONDYLOSIS BONE ISLAND, LI VERTEBRAL BODY

I used to have periods to where I could take a Tylenol and go on with my day like normal but ever since my lupus diagnosis in 2021 it’s just been getting worse and worse every month. I know lupus causes hormonal changes during that time but I didn’t think it would make it this bad. I’ve gone through so many things because of lupus like nephritis, pleural effusion, heart problems and the typical joint pain, etc, without strong pain medications but this is just insane. The only pain medicine that has actually helped me during my menstrual cycle has been morphine during a hospital stay, and well that’s not really an easy thing to get prescribed for just a period and it’s not a good thing to continuously take.
The on and off fevers for two days, the nausea, stomach cramps, my legs have so much pain, I turn blue, my whole body shakes randomly uncontrollably like shivers when you’re cold, but I’m not cold. I’ve never felt so horrible in my life. I’ve brought it up to my rheumatologist and my primary care doctor and everytime it’s just blown over like nothing. I’ve also been given a few prescriptions for menstrual pain and they never helped so I’m at a loss, I’ve tried heating pads, warm baths, those soothing oils, etc and still nothing. Everytime it happens I feel like I need to go to the hospital but wait times are 9+ hours so I stay home to deal with it, I have no idea if this is just lupus causing this or something else on top of it but it’s driving me crazy to the point where (this is gonna sound super crazy) ever since I turned 18 I have asked multiple times to have a hysterectomy because I feel like at this point it’s my only option to get rid of the pain and it triggering my lupus, but of course I know they say “wait until you’re older” “it’s not that serious” when to me it is that serious and I’m unsure of what else I could do for it. I always just thought lupus caused a slight elevation in the amount of pain from a period but I definitely thought wrong about that.
Does anyone have anything that’s helped them during this time? I’m willing to try anything at this point.

53M. 6'1". 185lbs.
Medications:
Aspirin
Atorvastatin (Lipitor)
Bepreve (bepotastine besilate ophthalmic solution)
Celecoxib (Celebrex)
Cialis
Diclfenac Sodium Topical
Losartan Potassium
Metoprolol Succinate Extended-Release
Zepbound
Naproxen Sodium (Aleve)
Nasonex
Sertraline (Zoloft)
Doctor recommended a cardiac CT angio and I received the results. This looks pretty scary. I mean, 99% of people have better hearts? I feel like I should just give up and wait to have the inevitable heart attack.
Here's the report:
CTA CORONARY ARTERIES 3D WITHOUT AND WITH CONTRAST
HISTORY: Coronary arteriosclerosis.
COMPARISON: CT calcium score from 04/30/2016 and 12/09/2020
TECHNIQUE: Gated CT angiography of the heart was performed with intravenouscontrast, using coronary protocol. Multiplanar reformatted and 3D maximumintensity projection (MIP) images were created and reviewed. The followingdose reduction techniques were utilized: automated exposure control and/oradjustment of the mA and/or KV according to patient size, and the use of aniterative reconstruction technique.
CONTRAST: Isovue 370 95 mL
FINDINGS:
CALCIUM SCORING:Left main: 65
Left anterior descending: 227
Left circumflex: 346
Right Coronary: 288
Posterior Descending: 0
TOTAL CAC SCORE: 926
AGE/SEX MATCHED SCORE PERCENTILE: 99% of asymptomatic patients matched for same sex and age have a lower calcium score.
CT CORONARY ANGIOGRAPHY:
LEFT MAIN: The left main coronary artery demonstrates calcified plaques which results in no significant luminal narrowing.
LEFT ANTERIOR DESCENDING CORONARY ARTERY: The proximal LAD demonstrates calcified plaques which results in minimal luminal narrowing (less than25%). The mid and distal LAD are patent without stenosis. The first diagonal branch demonstrates mixed noncalcified and calcified plaques which results in minimal luminal narrowing (less than 25%). The second diagonal branch demonstrates calcified plaques which results in minimal luminal narrowing (less than 25%).
LEFT CIRCUMFLEX CORONARY ARTERY: The proximal left circumflex demonstrates calcified plaques which results in minimal luminal narrowing (less than25%). The first obtuse marginal branch is small in caliber and difficult to assess. The second obtuse marginal branch appears patent. The third obtuse marginal branch appears patent. The mid left circumflex demonstrate scalcified plaques which results in minimal luminal narrowing (less than25%). The fourth obtuse marginal branch appears patent. The distal leftcircumflex is small in caliber and cannot be assessed.
RIGHT CORONARY ARTERY: The proximal RCA demonstrates calcified plaques which results in mild luminal narrowing (25-49%). The mid RCA appearspatent without stenosis. The distal RCA appears patent without stenosis.The PDA arises from the RCA and appears patent. Other: There is a 5 mm pulmonary nodule in the right lower lobe (series 14,image 41). The heart size is normal. There is no pleural or pericardial effusion.
IMPRESSION: 1. Nonobstructive coronary artery disease.2. Calcium score of 926.3. A 5 mm right lower lobe pulmonary nodule. Recommend a follow-up noncontrast CT chest in 1 year.

MIL (62) ended in hospital last Thursday due to pleural effusion. Bronchoscopy then total body scan. It’s cancer, spinal metastasis, the results of the histological examinations will get back at the end of next week. My dad was diagnosed with 4th stage prostate cancer 3 years ago at 64 yo, metastasis spread to bones and brain. He got hospitalised multiple times, twice we thought he wouldn’t get out, today he is alive, on a wheelchair but almost well. When it happened to me I wanted to know exactly what I was dealing with, so I spoke to my dad’s doctors, refused to be treated like a baby by my family members, took charge of his medications and did research from the very first day doctors said “cancer”. From the experience I got the idea that there’s always hope even when the prognosis looks terrible. I know (as my partner does) that lung cancer is no prostate cancer. Despite being my rock in these years, he is not proactive now. He didn’t want to speak with his mother’s doctor, he didn’t ask explanations about the possible outcomes, he just knows the situation is bad cause his dad and uncles who spoke to the doctors said so. They need to wait for the histological, and right know I’m just here to hug him when he needs to cry, I didn’t say a word.
Is there any advice you can give me? What is the worst possible outcome? What is the best? It kills me to see him this demoralised, I know he has every right to, but I feel it’s unfair to his mother, who’s a great woman, to give up on her already. Could there be hope? Thank you, sorry for the English.

I'm 48 years old and started having back pain that I hadn't had before. I wore a brace for awhile as a child, but hadn't even thought about having scoliosis for years. The doctor ordered x rays and I posted the results below. I'm having headaches and back pain that makes it hard to focus and causes fatigue. I've started taking muscle relaxers and NSAIDS and the make me tired, too. I survive the workday just to crawl into bed at 7 or 8pm.
I just wanted to see thers' thoughts on my possible prognosis and if anyone's been through similar.
Thanks.
FINDINGS/IMPRESSION: There is no coronal imbalance, pelvic tilt, or sagittal imbalance. There is S-shaped scoliosis of the spine. There is levoscoliosis of the lumbar spine the Cobbs angle of 20 degrees centered at L1. There is dextroscoliosis of the thoracic spine centered at T9 with a Cobbs angle of 46 degrees. There is multilevel degenerative disc disease.
Visualized bowel gas pattern is nonobstructive. Visualized lungs are clear. No pleural effusion or pneumothorax.
Workstation ID:C32059 Narrative EXAMINATION: XR SCOLIOSIS ENTIRE SPINE AP / LATERAL
HISTORY: Dextroscoliosis of thoracic spine, Strain of thoracic spine, initial encounter, Chronic neck pain, Chronic neck pain
COMPARISON: None

Hi all, I am 33F (non smoker) who was recently seen in the ED because I was coughing up a bit of blood. Not copious amounts but more than streaks you sometimes see in phlegm when you’re sick. My boyfriend recently has covid so one would assume I have picked that up despite testing negative twice. I have a pulmonary AVM in my right lung so they decided to do a chest CT to check on that. The results came back and honestly have me feeling a little uneasy. The results were the following:
FINDINGS:
LUNGS/PLEURA: New left lower lobe groundglass/consolidation focus measuring with regional endobronchial debris. Regional tree-in-bud nodularity also noted. Right upper lobe/apical pulmonary nodule measuring up to 8 mm, unchanged since 2019. No pleural effusion. No large pulmonary hemorrhage. No pulmonary contusion. The central airways are patent without debris. No pneumothorax.
IMPRESSION:

1. Left lower lobe regional groundglass/consolidative opacity with regional endobronchial debris, atelectasis, and tree-in-bud nodularity favored to represent infectious/inflammatory etiology such as a report evolving pneumonia. Recommend follow-up chest CT in 6-8 weeks to confirm resolution and rule out underlying lesion. At that time a right upper lobe nodule can be reassessed.
2. Right upper lobe pulmonary nodule is unchanged since 2019.

Can anyone explain these results to me in a way I can understand? They just had a nurse discharge me with a prescription for an antibiotic and said that it was likely an infection. I did have a slight cough when I was seen and have now gotten progressively worse. Horrible cough with fever. What is endobronchial debris? And what is a tree in bud nodularity?
Thanks in advance for any help and your time!

Hello everybody!
Im trying myself at echography when I have time at the Hospital.
So I was holding the transducer with the Marker poiting to the nose of the Patient. I was at a position where I could see the right atrium and the Vena Cava Inferior. On The screen, the Atrium was on the LEFT of the image, the Vena Cava followed on the right.
Now, using the same transducer I wanted to see if there was pleural effusion. The transducer marker was pointing up here again. I saw in the following order from left to right: Liver, small pleural effusion and then the lungs.
The way I'm trying to learn echo is the following: I'll imagine how the Ultrasound-beam is "cutting" through the anatomical parts that it goes through and I imagine myself facing that beam (as if it was a wall). It just lets me better imagine where I'm at 3D-wise and better guide the transducer to make the structures more clear on the screen.
Ok so now my question is the following: why is it that using the same transducer, with marker pointing up, structures that are on the same side as the marker sometimes appear on the left (first scenario, Atrium appeared on the left followed by Cava on the right) and sometimes on the right (second case where the lung appeared on the right followed by pleura effusion and then Liver on the left). Why is it that the rendered Image on the screen shows structures that are on the same side of the transducer marker, sometimes on the left and sometimes on the right? My brain is somehow not able to imagine how this would work in 3D (unless I imagine myself facing the "wall" sometimes on one side of it and sometimes on the other side, which would still let me with the question: why the hell does the transducer work like this for the same given marker-orientation ?).
I hope you guys get what I mean! Thanks in advance for your answers.

I (52F) went to A&E back in late February because I waws having trouble drawing a full breath. Thinking I was going to be Rx'd some inhalers and perhaps referred to the respirology (I've been having problems for years but have never formally been diagnosed with asthma), you can imagine my shock when I was advised that I was being admitted because they were unhappy with some cardiac blood work results (they're working through those as I type).
Anyway, I'm on a waiting list to be seen by the Respiratory service (appointment is in mid July) but I've been given access to the radiology report(s) from all of the film they took on the day of my visit to A&E (X ray/CT scan etc).

A HOSPITAL NEAR YOU Patient Name: SomeWomanFromCanada MIS Number: 8186935918824 Hospital Number: 295375063 10118287 22/02/2024 CT Angiogram pulmonary Clinical Question:SOB intermittent worse this today, raised d-dimer and troponin?PE Findings: No previous imaging available for comparison. Adequate opacification of the pulmonary artery trunk (350HU). No pulmonary embolism from the pulmonary artery trunk to the subsegmental levels. There is reflux of contrast into the hepatic veins, no other radiological evidence of right heart strain. There is patchy atelectasis and parenchymal infiltrate in both lower lobes. There are small granulomas noted in the right upper, lower lobe and the left upper lobe and scattered tiny sub 2mm nodules in the right middle and lower lobes. No pleural effusion or focal consolidation. No endobronchial lesions. No thoracic lymphadenopathy. Unremarkable appearance of the imaged upper abdominal viscera. No destructive osseous lesions. Conclusion: No pulmonary embolism. Non specific patchy atelectasis and parencymal infiltrate as desribed. Dr Cassian Andor Consultant Radiologist GMC 2266977 This report is generated for the referring clinician. Should patients have queries regarding the report, these should be discussed with the referring clinical team. Reported by: Dr Orson KRENNICK

Can anyone please tell me what to make of this report?
I''m most interested in the references to _patchy atelectasis_ and _parencymal infiltrate_
From my limited medical knowledge, there's something going on in my lungs but it's not cancerous or anything icky like that nor is it cardiac in nature or a blood clot.
FWIW, I am prone to getting bronchitis every time I get a head cold (regardless of how mild the cold is); in the winter, cold air triggers repeated episodes of bronchitis (when I lived in Canada, I carried a bottle of Buckleys Mixture and an oral syringe in my purse all winter every winter because it was the only thing that would come close to helping the cough).
I've also recently been prescribed a 'blue' salbutamol (rescue) inhaler and a Clenil Modulite 100mcg (beclamethasone) 'brown' (reliever) inhaler by my GP (while I wait for my appointment with the respiratory service) ... I've felt better since I've started using them (I had a lung function test this morning and haven't had the Clenil Modulite since Monday night and am feeling a little congested in my chest.
Anyway, I am new to all of this and I thank you all for a) reading this far and b) offering your collective wisdom as I try to figure out WTF is going on.

Two weeks ago I noticed my cat was breathing with her mouth and abdominal muscles. Turned out she had a pleural effusion, and cytology of the drainages showed “a lot of lymphocytes” per the emergency vet. She’s a fixed half Siamese (half DSH), about 10, 11 lbs, strictly indoors and vaccinated. Post op X-ray shows a large ventral mediastinum mass that spans almost the entire width of her chest and down to the 6th rib; lateral X-ray shows her lung being caudal to the 5th rib. After seeing the films, I thought she couldn’t possibly make it out of this, and asked the vet to put her on palliative care.
After the drainage and while on prednisone, she still has labored breathing although not half as severe as before, and she continues to hide under the bed. But her gums are pink, and her appetite is still amazing, if not better with the steroid - I think we gave her so much goodies that she actually gained weight in the past few days.
Maybe I'm just in bargaining, but I have a bit of hope for her surviving now. I am now contemplating the idea of getting her biopsied and chemo. However, I don't know if it's worth putting her through another procedure, or simply out on a car ride which she hates with a passion, if a poor prognosis can already be drawn from the information we have.
I guess my questions are: does the size of the mass and her age alone indicate a poor prognosis? And would a US vet ever give chemo based on cytology alone, without a biopsy of the actual tumor? Thanks in advance. I know I am likely just grasping at straws now, so no need to sugar coat it.

This is just venting because I'm so beyond frustrated. I've been on Ibrance since the beginning of January, when I first got prescribed my 1st month was free and my social worker said she'd be able to get me a $25,000 Co pay card. Well Pfizer changed it to 9k and of course this medicine is so very expensive that the 9k won't even cover 1 month. I have insurance through my job and it will only cover 5k which leaves me owing 10k every month and I'm not even close to rich so I can't afford it.
My oncologist and social worker have been amazing at getting me samples to keep me on this medication. In just 5 months my main tumor in my breast has gone from 12 cm to 3 cm and both lungs, the pleural effusion has subsided and no more nodules in the left and the ones on the right have shrunk a whole bunch. No progression at all, I'm very happy about it.
Fast forward to this past Thursday I had my appt and my oncologist tells me that one of her other patients had 3 boxes of Ibrance to donate but she couldn't take them because it's a clinic and against the law. She told her to go to the local voluntary medicine place because they accept donations and my Dr told me to head over there today so they can give me the meds, she said everything would be taken care of.
I head there today and these people were so condescending and rude to me. They treated me like an idiot and a nut job. They kept asking me why my Dr thought she had a right to refer me to them and I kept explaining my story. The lady said we don't have that medicine and even if we did we wouldn't give it to you because you're not a patient. So, I walked out of there with no meds and now have nothing for next month. I'm sure my oncologist will have a new treatment plan, but it's so annoying because I've been paying into the same insurance for 7 years and they are screwing me over. This is a life saving medication for me and I'm just being told nope. These pharmaceutical companies are a joke. How do they expect people to even pay for something that expensive?
I'm just bummed and sad that it's so difficult to get what I need. I want to scream. Thanks for letting me vent!

• Species: Cat
• Age: 10
• Sex/Neuter status: Male Neutered
• Breed: Domestic Shorthair
• Body weight: 10 lbs
• History: Diagnosed with Small Cell Lymphoma of GI two years ago. On Prednisolone and Chlorambucil. Multiple ultrasounds (including recent) and blood test shows no reoccurance of cancer in body. Recently brought to vet for unrelated symptoms. Lethargy, unable to really meow, excessive drooling, eye dischange, possible mouth pain, squinting
• Clinical signs: Extreme Lethargy, usually chatty cat doesnt really meow anymore, squinting eyes and a ton of discharge, nose running and recently been droollng alot. keeps making mouth smacking noises. been on and off going on a few weeks now. Seems to have hit a high point of fatigue today after his ER visit yesterday. One thing that caused me to bring him to ER was I was giving him his usual medicine and he kind of cried when I tried to open his mouth.
• Duration: 3 weeks
• Your general location: Northeast USA
• Links to any test results, X-rays, vet reports etc. that you have: Results attached. Blood tests came back OK. Platelet count confirmed OK. Ultrasound came back fine. Cat had fever of 104 going into vet and leaving it 6 hours later. Given sub fluids.

Here is a summary of the last couple visits:
4/29/24 AFAST: negative peritoneal effusion, no obvious abnormalities TFAST: La:Ao ~1:1, intermittent B-lines, negative pericardial/pleural effusion CBC: HCT 33%, WBC 11.96K, Neut 10K, Lymph 1.15K, Plt 220K Chem17/lytes: Glu 205, BUN 9, Creat 1.3, Phos 3.1, Ca 9.4, Na 156, K 3.5, Cl 118, TP 8.1, Alb 3.5, Glob 4.6, ALT 13, ALP 41, GGT 0, Tbili 0.1 PCV/TS: 32%/7.6, serum clear CXAXR: 1. The appearance of the stomach, small intestine and colon can be compatible with a nonspecific generalized functional ileus (e.g. gastroenterocolitis or infiltrative bowel disease such as IBD or the clinically reported gastrointestinal lymphoma). There is no evidence of small intestinal foreign material or mechanical obstruction. Consider initiation of therapy for generalized functional ileus and if clinically indicated, abdominal ultrasound might be pursued for further investigation. 2. Mild constipation. 3. Normal thorax. 4. Incidental small defect in the cranial endplate of L5 of uncertain etiology, likely a schmorl's node.
5/12/24 PCV/TS: 30/7.8 CBC: RBC 6.02 (L), HCT 29 (L), PLT 31 (L), bands suspected, rest unremarkable Blood smear: Majority of neutrophils appear toxic. Platelet clumping noted, suspect that platelet number is adequate. Chem17/lytes: Glu 177, rest unremarkable BP (doppler): 100mmHg FUO standard panel submitted to idexx Respiratory PCR panel submitted to idexx AUS with Radiologist: Conclusions/recommendations: 1) Mild gastritis. This is suspected to represent a secondary rather than primary condition however a flare up of small cell LSA cannot be completely excluded. Cursory evaluation of the cervical soft tissues did not reveal any abnormalities as well. Recommendations: Pending results of other testing, consider a GI panel if not recently performed, empirical treatment for gastritis and complete the work up for FUO
Treatments/Plan:
LRS 100ml SQ Ondansetron 0.5mg/kg SQ Convenia 8mg/kg SQ Rx mirtazapine TGH Rx famciclovir x 14d to pick up at pharmacy Rec to follow-up with pDVM in 1-2 days if CS not improving/worsening

39 year old male. Non smoker. Not on any meds, just vitamins and some supplements. No significant health issues.
Curious if anyone with more knowledge than me on such things has insight on this.
I just had a follow up chest CT to check on lung nodules that were found incidentally a year ago. They were stable on the most recent CT and no cause of concern / no further follow up.
The most recent CT report was much more detailed than the prior 2 I had — seems like the person doing it was just more detailed in his narrative (3 times as long)
The new incidentals weren’t flagged as important but was curious to learn more (my MD just said nothing of concern, hence I’m not concerned more so curious so I can file away the info).
The full report is below.
The two things I’m curious about
1) “Mildly prominent soft tissue density within the anterior mediastinum is likely thymic in origin”
Does this just mean they observed the thymus gland and it looked slightly different than normal? I’d been fighting a little infection and have had a messed up gut for a few weeks. Plus some abnormal stress. Not sure if relevant
2) first I’d heard of bone islands. I understand they are benign.
They weren’t called out on the prior CTs— is that likely due to prior Radiologists not finding them noteworthy enough to mention in prior reports?
———-
IMPRESSION: No acute pulmonary process is identified. Stable 8 x 4 mm subpleural nodule is seen within the right middle lobe. Other smaller pulmonary nodules are also stable. There is no new pulmonary nodule. No frank lymphadenopathy is seen within the chest.
Narrative
There are stable subcentimeter pulmonary nodules. For example, there is a stable, approximately 3 mm nodule within the anterior segment of the right upper lobe (series 201, image #75). There is a stable subpleural nodule seen within the right middle lobe, measuring approximately 8 x 4 mm (series 201, image #152). Other subcentimeter pulmonary nodules are also stable. There is no new pulmonary nodule. There is no pneumothorax or endobronchial lesion.
Pleural space: There is no pleural effusion.
Lower neck, lymph nodes, and mediastinum: There are no pathologically enlarged axillary, mediastinal, or hilar lymph nodes. Mildly prominent soft tissue density within the anterior mediastinum is likely thymic in origin.
Heart, pericardium, and thoracic vessels: The heart is normal in size. There is no significant pericardial effusion. Mild bilateral gynecomastia.
Bones and soft tissues: There is no destructive bony lesion. A few presumed bone islands are seen within the osseous structures.
Upper abdomen: Nonspecific wall thickening of the stomach likely relates to underdistention.

My 8 year old neutered FIV male cat has been diagnosed with lymphoma based on a physical examination, ultrasound and white blood cell count. The vet has not performed a biopsy. We have been advised against chemotherapy or palliative care and advised to euthanise. Aside from a pleural effusion which has now been drained he is otherwise fine. He has not displayed any “typical” lymphoma symptoms and is still eating/playing normally.
Has anyone got any experience of successfully ignoring vet advice to euthanise and pursue treatment?
My heart is broken so any help is greatly appreciated.

Middle Aged Man.
Lives in Medieval Times.
Is a noble.
Pleural Effusion.
Weakness in general.
Pain Just about anywhere.
Bouts Of fainting randomly.
Blood test show normal WBC's
Toxic Panel is negative. (could be smthing unconventional as he is a noble)
Edit New Symptom Discovered: Chronic Cough. (Could Be Unrelated)
New Symptom Discovered After CBC, Prothrombin, APTT, and Fibrinogen tests: Dysfibrinogenemia

My wife and I live in one part of our state and her parents are about 250 miles eastward. Her mother, now 75 years old and of normal weight and about 5'5" tall and Caucasian and of decently good health, has been in the hospital since at least three days ago. She initially presented with a fever and dizziness along with other general malaise. For about 48 hours the physicians there could not come up with an authoritative diagnosis. But yesterday, she was determined to have some sort of pneumonia condition. At least one of her lungs was drained of fluid 18-36 hours ago due to pleural effusion. My wife's father, 79, has been spending time there during the day; he is able to give my wife updates periodically on the phone. We are unsure if it is the viral or bacterial manifestation. Almost 10 1/2 years ago, I (57 now, M) had the bacterial kind and was treated with antibiotics and was in the hospital for almost 2 days and made a full recovery, and then in the fall of 2016 my wife (36 at the time) contracted it from a cold that she had a few days earlier and also had fluid evacuated from her chest and was able to go home almost a week later. She has done well since then. But there was a fear of septic shock at least briefly near when she was drained with a hypodermic needle on her lower back to alleviate the empyema. At what point in a more common pneumonia sickness would sepsis be especially threatening to recovery?
Does anyone have a general idea of how my mother-in-law might be able to recover based on her age and my description of her symptoms and the timing of everything? She still may have somewhat of a mid-grade fever. How long would antibiotics take to be fully effective once there is no excess buildup in her lung area, and does removing the fluid usually boost survivability significantly? Her primary Dr. supposedly has been somewhat involved, and/or another possibly, so I trust that her care is good. What would be the statistical survival rate for a person just now reaching 75? Her husband, my father-in-law, said to my wife on the phone that she may not be let out until about 5/14 and that the (fragile and touchy) recovery might be 6-8 weeks.
Thanks. This matter has made my wife and me, and others in the family, nervous and unrested.