Case 2 - Pleural Space
Indications:
Per Case 1, PoCUS was deployed to verify the presence of an effusion, assess its size, and whether there would be something else other than fluid and normal atelectatic lung present.
Image Acquisition:
Given the patient can sit upright, RZ6 was scanned first as it is views the most inferoposterial aspect of the thorax. The probe was first placed in the longitudinal axis.
Subsequently, the probe was rotated until it was parallel to the intercostal space in RZ6 for better visualization by ridding of the rib shadow.
Per Case 1, PoCUS was deployed to verify the presence of an effusion, assess its size, and whether there would be something else other than fluid and normal atelectatic lung present.
Image Acquisition:
Given the patient can sit upright, RZ6 was scanned first as it is views the most inferoposterial aspect of the thorax. The probe was first placed in the longitudinal axis.
Subsequently, the probe was rotated until it was parallel to the intercostal space in RZ6 for better visualization by ridding of the rib shadow.
Image Interpretation:
The sonographic images revealed a large mass rather than fluid in the right pleural space. This mass appeared pleural space in origin rather than parenchymal though it cannot be answered definitively.
There was, however, no safe pocket to perform a thoracentesis.
Clinical Synthesis:
A small right pleural effusion was found though no safe spot was identified for thoracentesis. Hence, CT chest to image the thorax was obtained to further characterize the lesion and the potential complexity of the pleural space.
The lesion, histologically a carcinosarcoma, was found to be tethered and originating from the parietal pleura.
The sonographic images revealed a large mass rather than fluid in the right pleural space. This mass appeared pleural space in origin rather than parenchymal though it cannot be answered definitively.
There was, however, no safe pocket to perform a thoracentesis.
Clinical Synthesis:
A small right pleural effusion was found though no safe spot was identified for thoracentesis. Hence, CT chest to image the thorax was obtained to further characterize the lesion and the potential complexity of the pleural space.
The lesion, histologically a carcinosarcoma, was found to be tethered and originating from the parietal pleura.