Presentation
Ex-smoker, right sided chest pain with cough and shortness of breath.
Patient Data
Right-sided lobulated and nodular pleural thickening, with volume loss.
Features highly suspicious for pleural malignancy.
CT Thorax with contrast for further evaluation advised.
CT confirms multiple solid pleural based masses throughout the right hemithorax.
The largest continuous mass extends along the anterior pleural surface to involve the mediastinum and invades the chest wall.
No rib invasion.
Fissural nodules also noted.
Moderate sized right pleural effusion.
The circumferential nature of the disease in the right hemithorax is suggestive of mesothelioma. An 8 mm right axillary lymph node is noted.
No enlarged supraclavicular, mediastinal or hilar lymph nodes.
No left-sided pulmonary nodules.
Unilateral discontinuous solid pleural masses invading the chest wall and mediastinum, suggestive of mesothelioma.
Case Discussion
In this case, ultrasound guided biopsy right-sided pleural biopsy was performed.
Histology confirmed sarcomatoid mesothelioma.
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