A 64 year old lady presents to the respiratory team with a 3 month history of progressive dyspnoea, chest pain and weight loss.
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Describe and interpret this CXR and CT chest
There is encasement of the right lung from pleural thickening in the right hemithorax with volume loss.
The left pleura is normal. There is a nipple shadow on the left.
CT chest demonstrates circumferential pleural thickening.
This is characteristic of malignant pleural mesothelioma.
This lady was a shop worker with no occupational exposure to asbestos; her husband was a carpenter – she was exposed to asbestos while washing his work overalls (‘para-occupational‘ exposure).