Lung Ultrasound Beyond the pleural line: a case of respiratory failure due to malignant mesothelioma

Background: Lung ultrasound (LUS) exerts a relevant role in early evaluation of lung and pleural diseases, especially in the emergency setting. In particular, LUS has been increasingly employed to differentiate malignant from benign pleural masses. Case Report: we report the case of a 85 years old caucasian male referred to our emergency department for the onset of dyspnea, fatigue and atypical chest pain. LUS showed a mass with mixed echogenicity and irregular contours at right hemitorax, near the diaphragmatic surface, suspected for malignant neoplasia. Subsequent chest computed tomography and histological examination confirmed the diagnosis of malignant mesothelioma. Conclusions: Mesothelioma is a challenging diagnosis for physicians due to no specific symptoms and lack of a reliable biomarker. LUS is a non-invasive and reliable imaging modality allowing to detect early signs of asbestosis and mesothelioma development such as pleural effuson, pleural thickening and masses.