Computed tomography findings in 66 patients with malignant pleural mesothelioma due to environmental exposure to asbestos

Our plain-English summary of Computed tomography findings in 66 patients with malignant pleural mesothelioma due to environmental exposure to asbestos, by F. Okten, D. Köksal, M. Onal, et al (Clinical Imaging, 2006).

The study

• Authors: F. Okten, D. Köksal, M. Onal, A. Ozcan, C. Simşek, H. Ertürk
• Journal: Clinical Imaging
• Published: 2006;30(3):177-80
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We aimed to investigate the computed tomography (CT) findings of malignant pleural mesothelioma (MPM) caused by environmental asbestos exposure. We retrospectively reviewed CT scans of 66 patients, which were performed before any invasive procedure was done. Pleural effusion (80.3%), pleural thickening (77.2%), volume contraction (37.9%), involvement of mediastinal pleura (31.8%) and interlobar fissure (28.8%) were the most common CT findings of MPM. Although none of these findings are pathognomonic for MPM, they may provide valuable clues for the differential diagnosis, at least in patients with a history of asbestos exposure.

In plain English

This study, from a hospital in Ankara, Turkey, looked back at computed tomography (CT) scans of 66 patients diagnosed with malignant pleural mesothelioma between 1998 and 2004. None had occupational exposure to asbestos, but all had a history of environmental exposure. All scans were taken before any invasive procedure. There were 45 men and 21 women, and nine patients (13.6%) were 40 or younger. The most common finding was fluid around the lung (pleural effusion), in 53 patients (80.3%). Next was pleural thickening, in 51 (77.2%), which was mostly nodular. Other findings were shrinkage of the affected side of the chest (volume contraction) in 25 (37.9%), involvement of the mediastinal pleura in 21 (31.8%), involvement of the interlobar fissures in 19 (28.8%), and calcified pleural plaques in 8 (12.1%). In four patients (6.1%), effusion appeared without any pleural lesion. The authors concluded that none of these findings is pathognomonic (unique to) mesothelioma, but they may give valuable clues for diagnosis, at least in people with a history of asbestos exposure. Because most biopsies were small, the authors could not compare findings by tumor subtype.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of CT scans in a series of patients with malignant pleural mesothelioma (descriptive case series)
• Who was studied: 66 patients (45 men, 21 women) diagnosed with malignant pleural mesothelioma at a chest diseases hospital in Ankara, Turkey, from 1998 to 2004; nine (13.6%) were 40 years old or younger
• Exposure: Environmental (non-occupational) exposure to asbestos; the article does not specify fiber types or doses for these patients
• Main results:
  • Pleural effusion was the most common CT finding, present in 53 of 66 patients (80.3%). It was massive in 22 (41.5%) and moderate in 31 (58.5%).
  • Pleural thickening was present in 51 patients (77.2%). Among these 51, it was nodular in 31 (60.8%), diffuse in 9 (17.6%) and a mass lesion in 11 (21.6%).
  • Volume contraction was seen in 25 patients (37.9%), mediastinal pleural involvement in 21 (31.8%), and interlobar fissure involvement in 19 (28.8%).
  • Calcified pleural plaques were present in 8 patients (12.1%).
  • In 4 patients (6.1%), pleural effusion was the only finding, with no pleural lesion.
  • The right side of the chest was affected more often (56.1%) than the left (42.4%). One patient (1.5%) had involvement of both sides.
  • Nine of the 66 patients (13.6%) were 40 years old or younger.
• The authors' conclusion: The authors concluded that pleural effusion, pleural thickening, volume contraction, and involvement of the mediastinal pleura and interlobar fissures were the most common CT findings. None of these is pathognomonic for mesothelioma, but they may provide valuable clues for diagnosis, at least in patients with a history of asbestos exposure.
• Limitations the authors state:
  • Most diagnoses came from small closed pleural biopsies that could not tell tumor subtypes apart (72.8% were recorded as undifferentiated), so the authors could not compare CT findings by histologic subtype.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Environmental Exposure, Asbestos Exposure, CT Scan, Pleural Effusion, Pleural Thickening, Pleura, Differential Diagnosis.

Related studies

• High-resolution computed tomography in cases with environmental exposure to asbestos in Turkey — F. Topçu, H. Bayram, et al. (2000)
• Fatal pleural mesothelioma in Japan (2003-2008): evaluation of computed tomography findings — K. Kato, K. Gemba, et al. (2016)
• The comparison of high-resolution computed tomography findings in asbestosis and idiopathic pulmonary fibrosis — M. Akira, K. Morinaga (2016)
• Findings from high resolution computed tomography of the lung and pleura of symptom free workers exposed to amosite who had normal chest radiographs and pulmonary function tests — S. Neri, A. Antonelli, et al. (1994)
• Malignant pleural mesothelioma caused by environmental exposure to asbestos in the Southeast of Turkey: CT findings in 117 patients — A. Senyiğit, H. Bayram, et al. (2000)
• High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust — J.M. Soulat, D. Lauque, et al. (1999)

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