An 86-year-old man presents with weight loss for 2 months and worsening shortness of breath for 2 weeks. An x-ray shows a left pleural effusion (fluid around the lung). Tests of that fluid removed with a needle (thoracentesis) show undifferentiated carcinoma. History, physical examination, routine laboratory tests and noninvasive imaging do not disclose the primary cancer. Could “metastatic undifferentiated carcinoma” be a sufficient diagnosis, or are additional studies needed? Does your answer change if he has late-stage Alzheimer’s disease?
Next problemBack to all Chapter 1 Problems
Back to all Chapters