Differential Diagnosis for Right Sided Chest Pain and Pleural Effusion
- Single most likely diagnosis
- Mesothelioma: Given the patient's symptoms of right-sided chest pain, dyspnea on exertion, weight loss, and the CT findings of pleural thickening and right-sided pleural effusion, mesothelioma is a strong consideration. The duration of symptoms (three months) and the presence of pleural thickening are particularly suggestive of this diagnosis.
- Other Likely diagnoses
- Adenocarcinoma: This is the most common type of lung cancer and can present with similar symptoms, including chest pain, dyspnea, and weight loss. Pleural effusion and pleural thickening can also be seen in adenocarcinoma.
- Small cell lung cancer: Although less common than adenocarcinoma, small cell lung cancer can cause rapid onset of symptoms, including weight loss and dyspnea. It can also lead to pleural effusions, though pleural thickening is less typical.
- Do Not Miss diagnoses
- Pulmonary embolism: While less likely given the chronic nature of the symptoms and the CT findings, pulmonary embolism can cause sudden onset of dyspnea and chest pain. It's crucial to consider this diagnosis due to its high mortality rate if missed.
- Tuberculosis (TB): TB can cause chronic symptoms, including weight loss, dyspnea, and chest pain, along with pleural effusions. It's a critical diagnosis not to miss due to its treatability and potential for severe consequences if left untreated.
- Rare diagnoses
- Large cell lung cancer: This is a less common type of lung cancer and might present with similar symptoms. However, it is less likely than adenocarcinoma or small cell lung cancer.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can involve the pleura and cause effusions, along with systemic symptoms like weight loss. It's a rare consideration but should be kept in mind, especially if other diagnoses are ruled out.