February 2011 Arizona Thoracic Society Notes

A dinner meeting was held at Scottsdale Shea Medical Center on February 15 from 6:30-8:00 PM. Twenty were in attendance including representatives from the pulmonary, chest radiology, and thoracic surgery communities. Several cases were presented and discussed: 1. Metastatic testicular cancer by Henry Luedy 2. A left pleural effusion with an inverted diaphragm was presented by Allen Thomas. Michael Gotway showed several cases from his teaching files of reexpansion pulmonary edema. A discussion ensued afterwards regarding the volume of fluid which can be safely removed at one time. The thoracic surgeons noted that they have removed large volumes during video-assisted thorascopy without any adverse consequences. It was felt that up to 1-1.5 liters could be removed safely but larger volumes probably required manometry; 3. Manny Mathew showed a case of hydropneumothorax after resection of a Coccidiodes cavity with subcutaneous air and multiple air-fluid levels including in the soft tissues. Discussion centered on management; and 4. Evan Schmitz presented a case of Nocardia in an immunocompromised host with a low FEV1 emphasizing the importance of aggressively pursuing the diagnosis.

Richard A. Robbins, MD