Presentation
Patient with a dry cough for one year. In recent months whitish expectoration has appeared. The patient reports he has not taken in account the symptoms.
Patient Data
There is evidence of concentric and irregular thickening of the pleura of the left hemithorax. It is associated with a decrease in the volume of this hemithorax and a deviation of the mediastinum to the left. It involves the fissures. It does not present associated calcifications. It infiltrates the extrapleural and pericardial fat. It is associated with a minimal basal pleural effusion. It reaches a maximum thickness of 18 mm at paramediastinal level. It measures approximately 12 mm in the dorsal region of the middle third of the hemithorax.
Multiple nodular images of millimetric size are identified in both lungs, which have soft tissue density. They present diffuse distribution, adopting a miliary pattern. Its secondary origin cannot be excluded. The largest one, located in the posterobasal segment of the LID, measures 5 mm.
There is evidence of a consolidating opacity in the basal region of the left lung, which does not show signs of air bronchogram. It could be of atelectasis origin.
There is also evidence of minimal interstitial thickening in the left lung, which could be of lymphangitic origin.
Case Discussion
This CT scan shows typical signs of mesothelioma although the final diagnosis will be defined by a biopsy. The patient denied any kind of contact with asbestos.
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