Presentation
Increasing exertional dyspnea and chest tightness.
Patient Data
Large left pleural effusion with bilateral calcified pleural plaques.
Malignancy requires exclusion.
Left pneumothorax with a pleural pigtail drain in the costophrenic recess.
Extensive fine nodular thickening of the left pleura involving the mediastinal pleura. No evidence of mediastinal, diaphragmatic or chest wall invasion. No lymphadenopathy.
Background calcified pleural plaques.
Plate atelectasis in the lungs. No appreciable lung mass. No anterior mediastinal mass.
Cholelithiasis.
Case Discussion
Surgical left pleural biopsy microscopic description: Invasive tumor formed by a proliferation of atypical epithelioid mesothelial cells forming solid nests. The cells have moderately pleomorphic nuclei with prominent nucleoli. No tumor invasion of the adipose tissue or skeletal muscle.
CK5/6, Calretinin and HBME1 Positive
TTF1 negative
Conclusion: Epithelioid Mesothelioma
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