Presentation
Fall. Query rib fracture.
Patient Data
Lobulated pleural opacity encasing the right lung, with associated volume loss.
No definite bony erosion / destruction or calcified pleural plaques seen.
Lobulated pleural soft tissue mass, encasing the right lung.
Associated erosion of the right 3rd rib anteriorly.
Calcified pleural plaques noted bilaterally, indicating previous asbestos exposure.
Case Discussion
Appearances are typical of pleural mesothelioma, especially given the evidence of underlying asbestos-related pleural disease.
Differentials to consider would be pleural metastasis or invasive thymoma with pleural spread (although these would be much less likely in this particular case).
CT guided biopsy of the pleural mass was performed, confirming malignant mesothelioma.