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We present a case of diffuse epithelioid malignant pleural mesothelioma in a patient with remote, short-term asbestos exposure complicated by recurrent left-sided hydropneumothoraces and pleural-based invasion of the T12 vertebral body, which represent two rare coexisting complications. This case illustrates the importance of maintaining a broad differential for hydropneumothorax, particularly as the risk factors may be decades removed and the degree of asbestos exposure to induce a malignant mesothelioma may be smaller than has been traditionally thought.<\/jats:p>","DOI":"10.1136\/bcr-2019-231987","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T05:49:19Z","timestamp":1578030559000},"page":"e231987","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Diffuse epithelioid malignant mesothelioma of the pleura presenting as a hydropneumothorax and vertebral body invasion"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6047-883X","authenticated-orcid":false,"given":"Colin Andrew","family":"Hinkamp","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, 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