A man of 60 years, diagnosed with hypertension with CVA cerebral hemorrhage and recovered in the year 2008. In the year, 2010 diagnosed DM treated. 3 months before gradually developed softness of voice from a bold voice. Laryngoscopy revealed slow motion of vocal cords. 3 days before felt very weak and appetite reduced to half and abdominal discomfort, wt loss noticed. Investigations done.
LT sided pleural effusion found and drained. 800 ml straw coloured fluid aspirated, high lymphocytes count 1200 cummand very high protein 1240 mg ADA 20 iu. X-ray next day showed a tumour like structure. Further examination showed RT a supraclavicular stony hard and 3 small stony hard lymph nodes at RT cervical region. Is it RT sided laryngeal ca and LT sided TB pleural effusion or it's all ca lung LT and metastasis RT side neck?
