Dilemma in Diagnosing Malignant Pleural Mesothelioma with  Atypical Clinical Presentation and Imaging Findings : Recurrent  Chylothorax, Mediastinal Lymphadenopathies and Pulmonary  Embolism

Author: Koa Ai Jiun ¹ ; Teh Yong Sim ²
Author Information

1. Radiology Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS) 94300 Kota Semarahan, Sarawak, Malaysia
2. Pusat Jantung Sarawak, Kuching, Semarahan Expressway 94300 Kota Semarahan, Sarawak, Malaysia
Publication Type:Case Reports
Keywords: Malignant pleural mesothelioma (MPM), Recurrent chylothorax, Pulmonary embolism, Mediatsinal lymphadenopathies
From:Malaysian Journal of Medicine and Health Sciences 2022;18(No.3):198-201
CountryMalaysia
Language:English
Abstract: Malignant pleural mesothelioma (MPM) is a rare malignant tumor affecting the mesothelium. It commonly manifests as pleural thickening on contrast enhanced CT (CECT) thorax. We reported a case of a young lady who presented with respiratory symptoms and was initially treated as pneumonia. However, she had recurrent episodes of chylothorax with progressive internal jugular vein (IJV), brachiocephalic vein and superior vena cava (SVC) thrombosis leading to pulmonary embolism, associated with extensive mediastinal and supracalvicular lymphadenopathies. There are no evidence of pleural thickening in the initial investigations. Our case highlighted that MPM must remain in the differential diagnosis for these presentations, albeit rare.
Full text:11.2022my1289.pdf