Pleural mesothelioma

Case contributed by Luu Hanh
Diagnosis probable

Presentation

Shortness of breath, chest pain.

Patient Data

Age: 70 years
Gender: Female
ct

Circumferential nodular pleural thickening that involves the costal, mediastinal, and diaphragmatic pleura in the right thoracic cavity, extending to the major and minor fissures. The mass invasive into the mediastinum. There is a tiny calcification of the nodule on the major fissure. 

No pleural effusion. CT abdomen is unremarkable(not shown).

Annotated image

Yellow arrow: nodular pleural thickening that involves the costal, mediastinal, and diaphragmatic pleura

Green arrow: small nodular opacities on interlobar fissures

Red arrow: Calcification of a nodule on the major fissure

Case Discussion

CT findings are representative of malignant pleural disease, which is likely mesothelioma or metastases.

The unilateral circumferential nodular pleural thickening, nodular fissures thickening, absence of hematogenous pulmonary metastasis, and no pleural effusion were findings indicating pleural mesothelioma rather than pleural metastases.

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