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2015, Number 3

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Anales de Radiología México 2015; 14 (3)

Computed tomography of malignant pleural mesothelioma: unusual image spectrum

Mejía-Duarte NA, Dena-Espinoza EJ, Rodríguez-Nava P, Angeles-Romero AA

Language: Spanish
References: 28
Page: 299-307
PDF size: 1063.50 Kb.


ABSTRACT

Malignant pleural mesothelioma is a neoplasm which usually occurs between the fifth and sixth decades of life. In 70% of cases it is associated with exposure to asbestos although the relationship between intensity and duration of exposure and the appearance of the disease is unknown.
Objective: Analyze unusual patterns, by computed tomography, of malignant pleural mesothelioma based on cases confirmed by pathology, to determine which image findings should be taken into account to establish a diagnosis.
Material and methods: We conducted a transverse study at Hospital General de Mexico, Dr. Eduardo Liceaga, in the period from January 2011 through March 2014. Thirty-eight (38) cases confirmed by pathology of malignant pleural mesothelioma were included and were compared with radiological diagnoses established by tomography.
Results: Of the 38 confirmed cases, in 11 (28.9%) the diagnosis by tomography was false positive, because they presented an image spectrum different from their usual behavior.
Conclusions: In some cases, both clinical and pathological and image diagnosis of malignant pleural mesothelioma can be difficult. Tomography achieves up to 90% sensitivity in this kind of findings. Malignant pleural mesothelioma should be differentiated from: adenocarcinoma, lymphoma, thymoma, metastasis, and infection. Due to the rarity of its occurrence, proper clinical, radiological, and pathological correlation should be sought, to obtain correct diagnosis and staging for effective treatment.


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