A 70 year old man with a 40 pack-year history of smoking and a previous occupation as a shipyard worker presents to the ER with chest pain, shortness of breath, and cough. On exam, you find diminished breath sounds on the right and decreased fremitus. While listening to the patient with a stethoscope, whenever he says "E" you hear "A." A lateral decubitus chest X-ray is shown above. Your attending makes the marks "A" and "B." After further evaluation, you do a biopsy of the pleura of the lungs.
Here's the biopsy:
The left is lower magnification while the right is a higher magnification image.
Challenge: What is the pathology shown in the biopsy?
1. What is the "E to A" change called?
2. What is shown on the CXR?
First image is in the public domain. Second image shown under fair use.