Sarcomatous malignant mesothelioma diagnosed after death

A 77-year-old man with diabetes mellitus who was being treated as an outpatient had abnormal shadow in the right lower lobe on a chest roentgenogram in June 1993. In July 1994, a productive cough developed, and subsequent dyspnea obliged him to enter our hospital. Retention of pleural fluid led us to suspect tuberculous pleurisy and to perform a pleural biopsy and a thoracentesis to remove pleural fluid, but no final diagnosis was reached. About 14 months later he died of dyspnea with a rapidly growing, tumor. An autopsy disclosed a giant tumor that occupied the right pleural cavity, excluding the lung. The tumor was well-defined between the lung and had infiltrated into the mediastinum. The histopathological diagnosis was primary malignant mesothelioma, sarcomatous type, of the visceral pleura.