Definition of Acute Empyema Thoracis

In this article, we will discuss the Definition of Acute Empyema Thoracis. So, let’s get started

Definition

It is defined as the collection of pus in the pleural cavity or grossly purulent effusion. The most common cause is bacterial pneumonia. 30-40% hospitalized cases of bacterial pneumonia have an associated pleural effusion. A small percentage of these parapneumonic effusions require drainage for their resolution and are called complicated parapneumonic effusion.

Recently, the term empyema has been broadened to include all these cases of complicated parapneumonic effusion. The characteristic feature of these effusions is exudative pleural effusion which contains significant number of WBCs (but less than empyema)and contains organisms as demonstrated by pathological (Gram stain and/or culture) tests.

(The term empyema was previously used for frank pus in the pleural space)

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Stages of Non-small cell Lung carcinoma

In this article, we will discuss the Stages of Non-small cell lung carcinoma. So, let’s get started.

Non-small cell lung carcinoma accounts for 85% of lung carcinIn this article, we will discuss the Stages of Non-small cell lung carcinomaoma and it includes:

Adenocarcinoma

Squamous cell carcinoma

Large cell carcinoma

Stages

I = Cancer is located only in the lungs and has not spread to surrounding lymph nodes

II = Cancer is located in the lung and nearby lymph nodes

III = Cancer is in the lung and in the lymph nodes in the middle of the chest. It is also described as locally advanced disease and it has following subtypes

  •    IIIa = If cancer has spread only to the lymph nodes present on the ipsilateral side of the chest where cancer started.
  •    IIIb = If cancer has spread to lymph nodes present on the contralateral/opposite side of the chest or above the clavicle. It is called stage IIIb

IV = Cancer has spread to both lungs, to fluid in the area around the lungs, or to another part of the body or organs such as liver, etc.

TNM classification of non-small cell lung carcinoma 8th edition

Tx – Tumor present in the sputum/bronchial washings but not be assessed in imaging or bronchoscopy.

T0 – No evidence of tumor

Tis – Carcinoma in situ

T1- < 3 cm surrounded by lung/visceral pleura but not involving the main bronchus

T1a(mi) – Minimally invasive carcinoma

T1a – 1 cm

T1b – 1 – 2 cm

T1c – >2 – <3 cm

T2 – >3 – < 5 cm or involvement of the main bronchus without carina, regardless of distance from carina or invasion visceral pleura or atelectasis or post obstructive pneumonitis extending to the hilum.

T2a – >3 – < 4 cm

T2b – >4 – < 5 cm

T3 – >5 – <7 cm in greatest dimension or tumor of any size that involves the chest wall, pericardium, phrenic nerve or satellite nodules in the same lobe.

T4 – >7 cm in greatest dimension or any tumor with invasion of diaphragm, mediastinum, heart, great vessels, recurrent laryngeal nerve, carina, trachea, esophagus, spine or separate tumor in the different lobe of ipsilateral lung.

N1 – Ipsilateral peribronchial and/or hilar lymph nodes and intrapulmonary nodes

N2 – Ipsilateral mediastinal and/or subcarinal lymph nodes

N3 – Contralateral mediastinal or hilar; ipsilateral/contralateral scalene/supraclavicular lymph nodes

M1 – Distant metastasis

M1a – Tumor in contralateral lung or pleural/pericardial nodule/malignant effusion

M1b – Single extrathoracic metastasis, including single non-regional lymph node

M1c – Multiple extrathoracic metastases in one or more organs