ABSTRACT
Background:Arterialhypoxaemiaisthecommonestcomplication,sincerespiratory depressantdrugsareusedforpremedication,andtheairwayisalsopartially occludedbythebronchoscope.Thestudyisthereforedesignedtofindoutthechangesinarterialoxygen tensionduring (FOB)alongwitheffectoncentral hemodynamics, pre andpost procedure ECGand PFT.Objectives were tofind out thechanges in arterial oxygentension during FOB, to study the effects of FOBon central hemodynamics, electrocardiographicallyand pulmonaryfunction tests.Methods:One hundred patients aged above 20 years undergoing FOB were evaluated for the arterial oxygen tension and cardiac rhythm changes at KNCH, Jodhpur during 12 months study period from 2019 to 2020.Results:All patients developed a fall in PaO2following FOB but hypoxaemia was noted only in 18 cases. Bronchial washing, punch biopsy and brush biopsy did contribute to hypoxaemia significantly. There was a uniform rise in heart rate in all the patients after FOB which was statistically significant. There was slight sinus tachycardia inmostofthecases although ECG indicated no major arrhythmias.ThepulmonaryfunctionswhichincludechangeinVC,FVC, FEV1andPEFR after FOB, on statisticallycomparisonnostatistical difference could be observed. Therewasnosignificantchangein PaCO2level and pH level.MeanofSBP andmeanofDBPwasstatistically significant.Conclusions:All patients showed a decline in arterial PaO2after FOB which was highly significant. There was slight sinus tachycardia in most of cases. FOB itself does not endanger the patients with any significant or serious complications.
ABSTRACT
Soft tissue tumors account for a small percentage of malignancies and synovial sarcomas account for 10% of soft tissue tumors in our body, among them are the synovial sarcomas (SS).These arise from various sites and are of mesenchymal origin, Primary pleural synovial sarcomas are very rare tumours and account for not more than 0.5% of lung malignancies, they are being diagnosed mainly by the immunohistochemistry and classical cytogentic translocation t(x;18). This tumor has no sex preference and is commonly seen in the age group of 30-45.Our case is of a elderly male with massive pleural effusion who was diagnosed as having biphasic variant of synovial sarcoma of pleura by the help of immunohistochemistry. Treatment is mainly surgical resection and chemotherapy with ifosfamide/ adriamycin or radiotherapy. It must be considered as differential for biopsy proven malignant mesothelioma and hence immunohistochemistry should be must for all biopsy proven mesotheliomas.