Pleural thickening

Case contributed by Dr. Ekaterina Peshevich

Patient Data

Age: 80 years
Gender: Female
X-ray

Chest radiographs demonstrate a pleural opacity on the right, which extends around and encases the lung. Reduction in volume of the affected hemithorax. Right breast shadow is absent and appears to have been removed.

CT

Soft tissue nodular mass which spreads along the pleural surface including into pleural fissures and creates a pleural rind, infiltrating the mediastinum, particularly at the level of the right atrium. No calcified pleural plaques are identified.

Case Discussion

Pleural metastases are an important differential given the previous mastectomy and presumed breast cancer. Since there is no pleural effusion, lymphadenopathy or rib destruction, the findings are more likely to represent pleural mesothelioma.

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