case_images: PMC4142470_01
case_images: 26-year-old female with chest pain and breathlessness diagnosed with pleural and peritoneal mesothelioma. Chest X-ray poster anterior view reveals opaque right hemithorax with areas of radiolucencies in the right mid zone (horizontal arrow). Right costophrenic angle and right hemi diaphragm silhouette is obliterated by soft-tissue opacity. There is no evidence of any calcification or bone destruction. Right side shows mild tracheal and mediastinal shift. Left lung field and costophrenic angle on the left side are clear.
case_images: JCIS-4-35-g002.jpg
case_images: PMC4142470_01_JCIS-4-35-g002.jpg
case_images: F1
case_images: The left side was clear [Figure 1].
case_images: 26-year-old female with chest pain and breathlessness diagnosed with pleural and peritoneal mesothelioma. Post-contrast CT coronal view shows contiguous rind-like soft-tissue attenuation pleural mass lesion encasing right hemithorax and scalloping of liver (horizontal arrow). Right side shows axillary lymphadenopathy (vertical arrow).
case_images: JCIS-4-35-g003.jpg
case_images: PMC4142470_01_JCIS-4-35-g003.jpg
case_images: F2
case_images: No pleural calcification was noted [Figures 2 and 3].
case_images: 26 year-old female with chest pain and breathlessness diagnosed with pleural and peritoneal mesothelioma. Post-contrast CT scan axial view shows pleural-based mass lesion (horizontal arrow) causing scalloping of the liver parenchyma with loss of extra pleural fat planes along the right lateral chest wall. No rib destruction is noted.
case_images: JCIS-4-35-g004.jpg
case_images: PMC4142470_01_JCIS-4-35-g004.jpg
case_images: F3
case_images: No pleural calcification was noted [Figures 2 and 3].
case_images: 26-year-old female with chest pain and breathlessness diagnosed with pleural and peritoneal mesothelioma. Post-contrast CT scan axial view shows soft-tissue attenuation pleural mass lesion completely encasing the right lung which shows consolidation collapse. Right lateral chest wall shows loss of extra pleural fat plane (horizontal arrow). However, no definite invasion of intercostal muscles is seen.
case_images: JCIS-4-35-g005.jpg
case_images: PMC4142470_01_JCIS-4-35-g005.jpg
case_images: F4
case_images: Chest wall showed loss of extra pleural fat planes at several locations; however, no definite invasion of intercostal muscles was seen [Figure 4].
case_images: 26-year-old female with chest pain and breathlessness diagnosed with pleural and peritoneal mesothelioma. Post-contrast axial CT sections from the pelvis show homogenously enhancing soft-tissue attenuation mass lesion (horizontal and vertical arrows) in the pelvis, abutting the small and large bowel loops without causing any obstruction. Ascites is also noted.
case_images: JCIS-4-35-g006.jpg
case_images: PMC4142470_01_JCIS-4-35-g006.jpg
case_images: F5
case_images: Ascites was also noted [Figure 5].
case_images: 26-year-old female with chest pain and breathlessness diagnosed with pleural and peritoneal mesothelioma. (a) Histopathology slide of the biopsy specimen. Hematoxylin and eosin staining of the lung biopsy sample (x400) shows malignant epithelial cells in acinar pattern (vertical arrow) infiltrating the lung tissue in a linear fashion (horizontal arrow). (b) Biopsy sample stained for Wilms' tumor protein shows nuclei positive (horizontal arrows) for the protein (x1000), which confirms the diagnosis of mesothelioma.
case_images: JCIS-4-35-g007.jpg
case_images: PMC4142470_01_JCIS-4-35-g007.jpg
case_images: F6
case_images: Hematoxylin and eosin staining of the lung biopsy sample showed malignant cells in acinar pattern and infiltrating in a linear fashion [Figure 6], which suggested the possibility of mesothelioma or adenocarcinoma.