Large amount of loculated pleural fluid in the right hemithorax, surrounding and compressing the right lung. The pleura is thickened and highly nodular. The superior part of the parietal mediastinal pleura compresses the superior vena cava. Right middle lobe (RML) compression atelectasis with air bronchogram. Smooth bronchial thickening on the right.
Small amount of pericardial effusion. The superior aortic recess is highly nodular, most probably shares the same pathology as the right pleura.
Small amount of left-sided pleural effusion.
No enlarged mediastinal of left hilar lymph nodes.
Impression: right pleural malignancy compressing the SVC, probably malignant mesothelioma.