Malignant Mesothelioma: Overcoming Diagnostic Hurdles

Cureus. 2024 Sep 5;16(9):e68718. doi: 10.7759/cureus.68718. eCollection 2024 Sep.

Abstract

Malignant pleural mesothelioma, an aggressive neoplasm frequently linked to asbestos exposure, is often detected at an advanced stage. This report details the case of a 58-year-old mason who presented with left-sided chest pain, and shortness of breath, accompanied by weight loss for a month. A positron emission tomography (PET) scan revealed increased uptake along the pleural surface, as well as in several mediastinal lymph nodes and the left supraclavicular lymph node. Thoracoscopy revealed the presence of multiple nodules on the costal pleura. Despite repeated negative results from pleural effusion cytology, cell block analysis, and pleural biopsies, the diagnosis of malignant mesothelioma (MM) was ultimately established through an ultrasound-guided (USG) biopsy of the left supraclavicular lymph node, with immunohistochemical confirmation using calretinin.

Keywords: asbestos exposure; calretinin positive; malignant pleural mesothelioma (mpm); massive pleural effusion; pleural neoplasm.

Publication types

  • Case Reports