What Is The Presentation Of Pleural Mesothelioma In A Patient?
Patients with pleural mesothelioma often have a presentation with insidious onset of dyspnea, nonpleuritic chest pain, cough, increased sputum production, weight loss, fevers, sweats and increasing weakness. On physical examination patients may have clubbing of the fingernails, dullness to percussion of the chest and decreased breath sounds of the lungs with auscultation caused by pleural effusion. Pleural effusion caused by mesothelioma will not have a mediastinal shift to the opposite side of the chest, as seen in typical pleural effusions, because of the restriction placed on the chest wall. With palpation of the chest wall there may be a coarse vibration, usually on inspiration, that suggest a pleural friction rub caused by inflammation of the pleural surfaces, the feeling is analogous to the feel of leather rubbing on leather. Patients usually have an occupational history of asbestos exposure, such as construction or ship yards.
