Chest X-ray ward round

Series 1: Case 6 Questions

Case 6:

An 81-year-old retired joiner presents with increased SOB from his GP

Chest CXR (Click to enlarge)

Questions:

What does the X-ray show?

Diaphragmatic pleural plaques which can also be visualized in the lung field

What is the diagnosis and differentials?

Asbestos related lung disease: Asbestosis, lung cancer, mesothelioma, pleural effusion

What is the management?

Investigations:

CT chest with high resolution reconstruction
Pleural fluid aspiration, image guided pleural biopsy

Treatment:

Pleural plaques are usually benign and require no treatment
If mesothelioma depending on fitness to decide on systemic treatment

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