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Hello and welcome to another exciting behind the knife clinical challenge with your Swedish

thoracic surgery team. I'm Kelly Dawes a third year surgery resident and I'm joined

today by my fabulous

attendings Dr. Peter White and Dr. Brian Louie.

Good afternoon.

Hi.

Also new to our podcasting crew today, we have Dr. Adam Bograd.

Dr. Bograd is another one of our wonderful thoracic surgeons

in our department here at Swedish

with a passion for all things thoracic oncology.

We're very excited to have him here with us today to discuss these

interesting cases. So today we are going to be talking about mesophilia

let's dive right in with a case.

You're asked to consult on a 50 year old female. She is previously healthy and presents with three months of cough and chest pain.

She initially attributed this to a lingering cold, but then started to have some night sweats and get more short of breath, so she saw her PCP.

Her PCP got a chest x-ray which showed this large right

floral effusion so the patient was sent to the ER for a diagnostic thoracenthesis.

Her output's a little bloody and concerning for malignancy so the ED provider gets a CT chest and all of a sudden sees these plural plaques but there's no evidence of any pulmonary nodules.

All right well let's pause here quickly.

You know, obviously this is an episode of a mesothelioma and so everybody's thinking that,

but Kelly, what's the broad differential diagnosis for this patient? Absolutely, I think for a lot of people their mind might not jump right to the

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