A 66 year old woman with breathlessness: case outcome

doi:10.1136/bmj.328.7445.944

BMJ 2004;328:944 (17 April), doi:10.1136/bmj.328.7445.944

Clinical review

Interactive case report

A 66 year old woman with breathlessness: case outcome

Douglas Lowdon, specialist registrar in medicine for the elderly¹, Marion McMurdo, professor of ageing and health²

¹ Royal Victoria Hospital, Dundee DD2 1SP, ² Ageing and Health, Division of Medicine and Therapeutics, Ninewells Hospital, University of Dundee, Dundee DD1 9SY

Correspondence to: D Lowdon douglas.lowdon@tpct.scot.nhs.uk

The first 150 words of the full text of this article appear below.

Five weeks ago (20 March, p 698) we described the case of MrsDempsey, who was investigated for suspected heart failure. Hersymptoms did not improve after initial treatment, and she hadfurther investigation to determine the cause of her bilateralpleural effusions (27 March, p 758). We then suspected an underlyingmalignancy, and she had computed tomography to assess her chestand extrapulmonary structures (fig 1). This showed large bilateraleffusions associated with widespread mediastinal, axillary,and abdominal lymphadenopathy. The likely diagnosis was nowadvanced lymphoma.

Fig 1 Computed tomography of thoraxshowing large bilateral effusions, 10 mm mediastinal node, and30 mm right axillary node

This right axillary node, which had not been detected on previousexaminations, was clearly palpable and a biopsy sample was taken.This confirmed the diagnosis of lymphoma. Immunohistochemistryresults were in keeping with a grade III follicular B cell non-Hodgkin'slymphoma. . . . [Full text of this article]

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A 66 year old woman with breathlessness: case progression: Douglas Lowdon and Marion McMurdo
BMJ 2004 328: 758. [Extract] [Full Text] [PDF]

A 66 year old woman with breathlessness: case presentation: Douglas Lowdon and Marion McMurdo
BMJ 2004 328: 698. [Extract] [Full Text] [PDF]

Rapid Responses:

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axillary node now appears: any comment on raised JVP?: Ramakant sharma
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