A 78-year-old man was referred to our department with a one-week history of dyspnea and coughing. A chest X-ray showed massive left pleural effusion. Computed tomography revealed diffuse irregular thickening of the left pleura similar to malignant mesothelioma and multiple nodules in both lungs. The patient died of respiratory failure nine days after hospitalization. An autopsy revealed metastasis to the pleura and lungs from urothelial carcinoma of the left kidney.

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http://dx.doi.org/10.2169/internalmedicine.53.1309DOI Listing

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Article Synopsis
  • Doctors sometimes think people have mesothelioma, which is a type of cancer, even when it's actually a different disease.
  • In a study with over 4,000 cases, 311 were wrongly diagnosed as mesothelioma, mostly mistaken for cancers coming from the lungs or kidneys.
  • The study showed that paying closer attention to medical images and doing more tests can help doctors avoid these mistakes and tell the difference better.
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Endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA), a minimally invasive procedure, may be useful for the diagnosis of pseudomesotheliomatous (PMC) carcinoma because a sufficient amount of tissue can be obtained for diagnosis. This is the first report of PMC diagnosed using EUS-B-FNA. Our findings suggest that EUS-B-FNA may reduce the risk of dissemination for PMC.

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Malignant mesothelioma (MM) has a wide range of clinical, radiologic, and pathologic presentations, mimicking lung cancer or interstitial lung diseases when predominantly involving the lung parenchyma. The case herein refers to a 79-year-old man, active smoker without asbestos exposure, incidentally discovered to have a pulmonary nodule in the right upper lobe (1.5 cm).

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