skip to main content

Malignant pleural mesothelioma — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

ModerateLung cancerMalignant pleural mesotheliomaSCE Respiratory

A 71-year-old retired builder has weight loss and right pleuritic pain. CT shows circumferential nodular pleural thickening encasing the right lung, volume loss of the hemithorax and a small pleural effusion. Pleural fluid cytology is negative and he has a 30-year latency from asbestos exposure. Spirometry shows a restrictive pattern. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Malignant pleural mesothelioma

Circumferential nodular pleural thickening with contraction of the hemithorax after asbestos exposure is highly suggestive of mesothelioma. Tuberculous pleuritis can cause lymphocytic effusion but does not usually encase the lung in this pattern. Negative cytology does not exclude mesothelioma, so pleural biopsy is often needed.

Reference: NICE NG122 Lung cancer; BTS Pleural Disease Guideline 2023