Pleural metastases

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Shortness of breath.

Patient Data

Age: 70 years
Gender: Male
x-ray

Bilateral pleural thickening present peripherally. Possible focal pleural calcification in the left lower zone.

Normal cardiomediastinal contour. No destructive bone lesion.

ct

No filling defect demonstrated within the pulmonary arteries to suggest a pulmonary embolus.

Extensive lobulated pleural based masses are present bilaterally. Pleural calcification is also noted. Changes of centrilobular emphysema throughout both lungs.

Band of linear atelectasis in the right lower lobe.

Mediastinal and hilar lymphadenopathy, particularly on the right. Upper abdominal para-aortic lymphadenopathy is also noted. No pleural or pericardial effusion. Left adrenal mass.

Mixed lytic/sclerotic destructive bone lesions within T10 and L1 vertebrae with breach cortical margin of the spinal canal at L1. Sclerotic foci within the ribs are also noted.

Case Discussion

This patient had a history of prostate cancer, and the findings are consistent metastatic pleural disease with further mediastinal/hilar, skeletal and left adrenal metastases.

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