CT - 3 weeks follow-up
There is circumferential mass-like pleural thickening encasing the right lung. This extends from apex to base and measures soft tissue density at 30-40 HU on pre-contrast and 60-70 HU on post-contrast imaging. At this stage, there is no right hemithoracic volume loss with a central trachea and cardiomediastinum. There is no trans diaphragmatic extension, no extrathoracic invasion, no rib or thoracic vertebral involvement, and there are no suspicious retrosternal, hilar or mediastinal lymph nodes. The mass is inseparable from the right pericardium however there is no transpericardial involvement and there is no pericardial effusion. The left basal pleural reaction on chest X-ray is confirmed to represent a small simple pleural effusion, with no nodularity, and no abnormal enhancement. There are bi-basal interstitial changes, right basal compressive atelectasis and non-specific right basal ground glass attenuation. There are no suspicious parenchymal nodules bilaterally. Importantly there are no calcified pleural plaques, and no features to suggest asbestos exposure or asbestosis.