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Updated: Feb 7, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
1.6K
An unusual case of pleural nodularity
Ruth Williams1, Helen E Davies1
1Respiratory Department University Hospital of Wales Cardiff UK.
Respirology Case Reports
|August 2, 2018
Summary
Metastatic prostate cancer can present as unusual pleural disease, mimicking primary lung cancer. This case highlights the importance of considering prostate cancer in men with unexplained pleural findings and elevated PSA.
Area of Science:
- Oncology
- Pulmonology
- Pathology
Background:
- Prostate cancer commonly metastasizes to lymph nodes and bone.
- Pleural involvement in prostate cancer is often asymptomatic and underdiagnosed during life.
Observation:
- A 65-year-old man presented with an incidental left lower-zone opacity on chest radiograph.
- Thoracic CT revealed widespread pleural nodularity, fissural/diaphragmatic involvement, and mediastinal lymphadenopathy.
- Initial pleural biopsy confirmed adenocarcinoma but failed to identify the primary site.
Findings:
- Staging CT identified bony metastases and an irregular prostate with elevated PSA levels.
- Immunohistochemistry confirmed prostate-specific antigen (PSA) positivity, establishing a diagnosis of metastatic prostate cancer.
- This case illustrates a rare presentation of prostate cancer with significant pleural metastasis.
Implications:
- Highlights the diagnostic challenge of metastatic prostate cancer presenting as primary pleural disease.
- Emphasizes the utility of PSA testing and immunohistochemistry in diagnosing unusual cancer presentations.
- Suggests increased vigilance for prostate cancer in older men with unexplained pleural abnormalities.
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