1st April 2022

A 70-year-old retired construction and maintenance worker presents to his GP

A 70-year-old retired construction and maintenance worker presents to his GP with a 3-month history of increasing breathlessness, chest pain, unintentional weight loss, and progressive fatigue. Physical examination reveals finger clubbing and decreased breath sounds in the right lung base associated with stony dull percussion. He has never smoked and has no significant past medical history.

His basic observations are: T 36.9, Oxygen saturations 93%, RR 23, HR 95, BP 145/95.

The chest X-ray shows a unilateral pleural effusion and irregular pleural thickening.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.