History :
A 71-year-old male developed cough, dyspnea and chest tightness in recent months.

Questions:

1. What are the findings?
2. What is the differential diagnosis?
3. What is the final diagnosis?

Answers:

1. CXR: suspicious hazy lesion in the LUL and left pleural effusion with lobulated outline. Chest CT: a large heterogeneous soft tissue density tumor in the LUL with pleural tumor implantation and massive loculated effusion.
2. left lung Ca with left pleural tumor implantation, mesothelioma
3. left Lung Ca with left pleural tumor implantation