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We report a case with a history of occupational asbestos exposure in which malignant pleural mesothelioma (MPM) was suspected clinically and diagnosed postmortem as pleural involvement of extrapulmonary small cell carcinoma (SCC). An 85-year-old man with a 65 pack-year history of smoking was referred to our hospital in June 2011. The patient had been exposed to asbestos in the iron production industry over the course of 30 years, and an irregular thickening of the right pleura was observed on chest CT at a medical check-up. The patient had a history of chronic hepatitis C and had been undergone transurethral resection for urothelial bladder cancer five times since 2006. Chest CT revealed neoplastic thickening of the right pleura, which had grown over 6 months (figure 1). The CT scan demonstrated bilateral pleural plaques, but no mass-like lesion in other organs, including the lungs, or mediastinal lymphadenopathy. The patient was suspected as having MPM and scheduled for thoracoscopic pleural biopsy, but his general condition worsened rapidly and he …
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