A 42-year-old man with progressive dyspnea and a rapidly growing mass

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A 42-year-old man with progressive dyspnea and a rapidly growing mass Jinesh P. Mehta, Juan Guardiola Respiratory Medicine CME Volume 4, Issue 4, Pages 151-153 (January 2011) DOI: 10.1016/j.rmedc.2011.05.002 Copyright © 2011 Terms and Conditions

Fig. 1 Chest radiograph. Chest radiograph on presentation reveals opacification of right hemithorax with pleural thickening. Respiratory Medicine CME 2011 4, 151-153DOI: (10.1016/j.rmedc.2011.05.002) Copyright © 2011 Terms and Conditions

Fig. 2 CT scan of the chest (Initial). CT chest (with intravenous contrast) showing a large right pleural effusion with nodularity and thickening of the pleura. Respiratory Medicine CME 2011 4, 151-153DOI: (10.1016/j.rmedc.2011.05.002) Copyright © 2011 Terms and Conditions

Fig. 3 CT scan of the chest (3 weeks subsequent to presentation). CT chest (without IV contrast) showing increasing thickening and nodularity of the pleura, along with the large pleural effusion. Respiratory Medicine CME 2011 4, 151-153DOI: (10.1016/j.rmedc.2011.05.002) Copyright © 2011 Terms and Conditions

Fig. 4 Pleural biopsy. Hematoxylin and Eosin stained (A, B) pleural biopsy sections at 40x magnification showing pleomorphic spindles and epithelioid populations. Electron micrograph (C) showing cytoplasmic primary and secondary lysosomes and lack of villi on tumor cell surfaces (microvilli are specific for mesothelial cells). Respiratory Medicine CME 2011 4, 151-153DOI: (10.1016/j.rmedc.2011.05.002) Copyright © 2011 Terms and Conditions

Fig. 5 Gross pathology (Autopsy). Autopsy revealed a tan, 35 × 27 × 10 cm fleshy, focally hemorrhagic mass encasing the right hemithorax, from the apex of the chest cavity to the diaphragm inferiorly and to the anterior and posterior mediastinum medially. Respiratory Medicine CME 2011 4, 151-153DOI: (10.1016/j.rmedc.2011.05.002) Copyright © 2011 Terms and Conditions