Transdiaphragmatic invasion of pleural mesothelioma
Known pleural mesothelioma presenting with abdominal distension and discomfort
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Multiple solid tumour nodules are present in the left lung base. They are pleurally-based and represent deposits of mesothelioma. They are both lateral and in the posterior costophrenic sulcus with subtle but definite penetration of tumour through the diaphragm (arrows) into the left subphrenic space as well as extending into the chest wall posteriorly (arrow). This is associated with considerable oedema and thickening of the omentum together with increased vascularity and ascites.
Mesothelioma is one of the few tumours that crosses anatomical planes - such as the chest wall and diaphram. In this case both have occurred!