Pathologic quiz case: a 39-year-old man with diffuse pleural thickening and massive hemothorax. Epithelioid angiosarcoma of pleura.

Abstract

39-year-old man presented in the emergency room with complaints of movement-dependent, right-sided chest pain radiating to the right shoulder; shortness of breath; blood-tinged productive cough; and a single syncopal episode not associated with urinary or fecal incontinence. Physical examination revealed decreased breath sounds and increased vocal fremitus in the right lung. Chest radiograph on admission revealed a right pleural effusion and soft tissue densities on the right lung base. A subsequent contrast computed tomographic scan of the chest showed a complex right pleural effusion and diffuse right pleural thickening, which extended from the apex to the base (Figure 1). Computed tomography of chest, abdomen, and pelvis showed no sign of tumor metastases. His medical history was significant for panic disorder, lumbar radiculopathy (L5-S1) on maintenance steroid