What are the main differentials for nodular pleural thickening?
1. Mesothelioma (look for other asbestos exposure signs) 2. Metastases (particularly lung, breast or thymic) 3. Lymphoma
Does smoking increase the risk of mesothelioma?
No. The vast majority of mesothelioma cases are asbestos-related. This is in contrast to asbestos-related lung cancer which is markedly increased with smoking (55 times). (Robbins 10th Ed)
What are the asbestos related disease processes?
1. Pleural plaques (the most common manifestation) 2. Pleural effusions 3. Pulmonary interstitial fibrosis (asbestosis) 4. Lung carcinoma 5. Mesothelioma 6. Laryngeal and ovarian carcinoma
What are the histological types of mesothelioma?
1. Epithelioid (60-80%) 2. Sarcomatoid (10-12%) 3. Biphasic (10-15%) (Robbins 10th Ed)
Left pneumothorax with a pleural pigtail drain in the costophrenic recess.
Extensive fine nodular thickening of the left pleura involving the mediastinal pleura. No evidence of mediastinal, diaphragmatic or chest wall invasion. No lymphadenopathy.
Background calcified pleural plaques.
Plate atelectasis in the lungs. No appreciable lung mass. No anterior mediastinal mass.
Cholelithiasis.