Differential Diagnosis for Nonsmoker Female with Lung Cancer and Pleural Effusion
- Single most likely diagnosis:
- Adenocarcinoma of the lung with malignant pleural effusion: This is the most common type of lung cancer in nonsmokers, and the presence of a hilar mass with pleural effusion suggests metastatic disease. The finding in thoracocentesis would likely be A. Pleomorphin glandular cell, which is consistent with adenocarcinoma.
- Other Likely diagnoses:
- Lymphoma: This could present with a hilar mass and pleural effusion, and the thoracocentesis might show B. lymphocytes.
- Mesothelioma: Although less common in nonsmokers, mesothelioma can present with a pleural effusion and a hilar mass. The thoracocentesis might show malignant mesothelial cells, but this option is not listed.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Tuberculosis (TB): Although less likely in this scenario, TB can present with a hilar mass and pleural effusion. The thoracocentesis might show B. lymphocytes, and it's crucial to consider TB due to its treatability and potential for severe consequences if missed.
- Rare diagnoses:
- Plasma cell dyscrasias (e.g., multiple myeloma): This could present with a pleural effusion, but it's less likely given the hilar mass. The thoracocentesis might show C. plasma cell, but this is a rare cause of lung cancer and pleural effusion.
- Other rare tumors (e.g., thymoma, germ cell tumors): These might present with a hilar mass and pleural effusion, but they are less common and might not have specific findings on thoracocentesis.
Given the options provided, A. Pleomorphin glandular cell is the most likely finding in thoracocentesis, consistent with adenocarcinoma of the lung.