Chest X-ray ward round

What does the X-ray show?

• Right sided intercostal chest drain
• Loculated right sided effusion
• Peripheral soft tissue pleural lesion and apical rounded density

What is the diagnosis and differentials?

• Pulmonary/pleural malignancy/metastases
• Small cell/ non-small cell carcinoma, mesothelioma

What is the management?

• Detailed medical history (occupation/ asbestos exposure)
• CT chest, abdomen and pelvis
• May need image guided tissue biopsy
• Depending on patient fitness (WHO performance status) and staging CT to consider systemic anti-cancer therapy via MDT