title: Pulmonary manifestations of renal cell carcinoma.
abstract: Renal cell carcinoma (RCC) accounts for majority of all primary renal neoplasms. Classic manifestations of RCC include the triad of flank pain, hematuria and a palpable renal mass. Patients with RCC can develop various extra renal manifestations including involvements of the lungs, inferior vena cava, liver and the bones. The pulmonary manifestations of renal cell carcinoma include metastatic disease including endobronchial, pleural, parenchymal or lymph node metastasis, pleural effusion or hemothorax. Pulmonary embolism and tumor embolism is another common manifestation of renal cell carcinoma. RCC is a highly vascular tumor and can cause pulmonary arterio-venous fistulas leading to high output failure. Rarely, RCC can also present with paraneoplastic presentations including cough or bilateral diaphragm paralysis. Drugs used to treat RCC have been associated with drug related pneumonitis and form an important differential diagnosis in patients with RCC on therapy presenting with shortness of breath. In this review we discuss the various pulmonary manifestations of RCC. A high index of suspicion with these presentations can lead to an early diagnosis and assist in instituting an appropriate intervention.
authors.affiliation: Monmouth Medical Center, Department of Medicine, 300 Second Avenue Long Branch, NJ 07740, United States. Electronic address: abhinav72@gmail.com.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Agrawal
authors.affiliation: North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, 410 Lakeville Rd. Suite 107, New Hyde Park, NY 11040, United States; Feinstein Institute for Medical Research, Center for Heart and Lung Research, 350 Community Drive Manhasset, NY 11030, United States. Electronic address: sahni.sonu@gmail.com.
authors.forename: Sonu
authors.initials: S
authors.lastname: Sahni
authors.affiliation: North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, 410 Lakeville Rd. Suite 107, New Hyde Park, NY 11040, United States; Feinstein Institute for Medical Research, Center for Heart and Lung Research, 350 Community Drive Manhasset, NY 11030, United States. Electronic address: doctorasmi@gmail.com.
authors.forename: Asma
authors.initials: A
authors.lastname: Iftikhar
authors.affiliation: North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, 410 Lakeville Rd. Suite 107, New Hyde Park, NY 11040, United States; Feinstein Institute for Medical Research, Center for Heart and Lung Research, 350 Community Drive Manhasset, NY 11030, United States. Electronic address: arunabh@nshs.edu.
authors.forename: Arunabh
authors.initials: A
authors.lastname: Talwar
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D006801:Humans; D007680:Kidney Neoplasms; D008175:Lung Neoplasms / Q000556:secondary*; D009360:Neoplastic Cells, Circulating; D010996:Pleural Effusion / Q000209:etiology; D011014:Pneumonia / Q000139:chemically induced; D011655:Pulmonary Embolism / Q000209:etiology; D016156:Respiratory Tract Fistula / Q000209:etiology; D017565:Sarcoidosis, Pulmonary / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents
keywords: Lung metastasis; Pleural effusion; Pulmonary manifestations; Renal cell carcinoma; Sarcoid like reaction; Tumor thromboembolism