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January 07, 2005

Medical mystery

The Cheerful Oncologist presents a fascinating diagnostic puzzle:

The patient is a 60 year old man with a pleural-based mass, a large mediastinal mass and a pleural effusion. Biopsy of the pleural mass revealed mesothelioma [a cancer caused only by asbestos exposure]. He has a history of smoking. He works as an manager for a construction firm but does not visit construction sites until they are finished - denying any exposure to asbestos through his job.

He denies helping with any demolition of a friend's house, or working in the railroad as a teenager, or living in a home where asbestos was present or brought home on work clothes. He simply cannot think of any time in his life when he was around such materials that could contain asbestos, and I was stumped at the end of our interview.

One week later, he volunteered a new piece of evidence about his past. [...]

If you think you know how this patient might have been exposed to asbestos, leave a comment for TCO.


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Although I gather (from the comments section) that this is not considered to be the source, it could have been Kent cigarettes' wildly nasty "micronite" (read ASBESTOS) filters, used for a few years in the 50s.

How long would this case have taken Dr.House* to solve? He would have first assumed that the patient was not being truthful [everybody lies] and while this was a ommission,how do you forget a factor so significant.
* Fox's resident diagnostician: Tues.nights. Hugh Laurie superb.

Kent micronite filter with asbestos is the silent killer.

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