Contributed by Su Zheng, MD, PhD and Mona Melhem, MD
Published on line in May 2000
The patient was a 34-year-old white man with no significant past medical history, who presented to VA Emergency Care Center on 12/22/99, with complaints of dyspnea, chest pain and 80-lb weight loss during the past few months. His chest CT revealed "a large right lung mass involving the pleura and chest wall, and compressing the heart". Echocardiogram showed "EF 20% with global myopathy". The patient had smoked 1.5 package per day for 25 years and was a farmer working with herbicides. On 12/23/99, he suddenly developed cardiac arrest and expired. A complete autopsy was performed.
CT scan of the chest showed a large irregular mass in the right lung near the hilum. There was marked nodular pleural thickening encasing the entire right lung (Figure 1). The heart was severely enlarged and compressed by the tumor. The anterosuperior mediastinum as well as the left lung were free of tumor (Figure 2).