CT findings in benign fibrous mesothelioma of the pleura: pathologic correlation in nine patients

Our plain-English summary of CT findings in benign fibrous mesothelioma of the pleura: pathologic correlation in nine patients, by K.S. Lee, J.G. Im, K.O. Choe, et al (AJR. American Journal of Roentgenology, 1992).

The study

• Authors: K.S. Lee, J.G. Im, K.O. Choe, C.J. Kim, B.H. Lee
• Journal: AJR. American Journal of Roentgenology
• Published: 1992;158(5):983-6
• Cited by: 80 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The CT findings in cases of benign fibrous mesothelioma of the pleura have been described previously, but little attention has been given to a correlation of these findings with the pathologic appearance of the tumors. Accordingly, we analyzed the CT scans in nine proved cases in which pathologic studies were available and compared the pathologic findings with the CT appearance of the tumors. On enhanced CT scans (available in eight patients), the lesions showed significant enhancement in all cases. Pathologic examination showed that the enhancement could be explained by the vascularity of the tumor. Areas of myxoid (n = 7) or cystic (n = 3) degeneration and hemorrhage (n = 3) seen in the pathologic specimens correlated with round or tubular low-attenuation areas on unenhanced and enhanced CT scans. On unenhanced CT scans (n = 3), the tumor density was the same as that of the surrounding musculature. Calcification was seen in one patient. Large lesions showed lobulated borders, but no invasion into the lung parenchyma and chest wall was noted. There was no pleural effusion. Our experience suggests that intense enhancement of the tumors occurs because of the vascularity of the tumors. Areas of low attenuation in the tumors on CT were due to foci of myxoid or cystic degeneration and hemorrhage in the lesion.

In plain English

This study compared CT (computed tomography) scans with the surgically removed tumors in nine patients with benign fibrous mesothelioma of the pleura. The patients were treated between January 1985 and January 1991, and their cases were collected from four institutions. Scans taken with contrast dye were available for eight of the nine patients, and in all eight the tumors appeared mostly bright (high attenuation). In the four patients where it was measured, the tumors averaged 121 H (a CT density unit), compared with 65 H for the surrounding muscle. Blood vessels were found throughout the tumors in all cases. Darker (low-attenuation) areas on CT matched areas of myxoid degeneration in seven patients, cystic degeneration in three lesions and bleeding in three cases. One tumor contained dense calcification. No patient showed tumor invasion into the surrounding muscle or bony chest wall, and none had pleural effusion. No tumors recurred during follow-up of 4 months to 6 years. The authors concluded that their experience suggested the strong brightening of the tumors occurred because of their blood vessels. The study did not examine asbestos exposure. The authors' introduction states there is no evidence these tumors are related to asbestos exposure.

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 case series correlating CT findings with pathologic findings
• Who was studied: Nine patients with pathologically confirmed benign fibrous mesothelioma of the pleura (five men, four women, aged 23-71, average 48), selected from 11 consecutive patients treated January 1985 to January 1991 and collected from four institutions; the authors are from Korean universities
• Exposure: No asbestos or other exposure was studied; the study examined CT imaging of the tumors. The authors' introduction states there is no evidence of a relationship to asbestos exposure.
• Main results:
  • Enhanced CT scans were available in eight of the nine patients (six with enhanced scans only, two with both), and the tumors showed predominantly high attenuation on enhanced scans in all of them
  • In four patients measured, enhancing tumors averaged 121 H versus 65 H for surrounding musculature
  • Vascular structures were scattered throughout the lesion in all cases
  • Areas of myxoid degeneration showed tubular or round low attenuation on CT in seven patients
  • Areas of cystic degeneration in three lesions appeared as round fluid-attenuation areas on CT
  • Hemorrhagic areas in three cases showed low attenuation
  • Dense calcification was seen in one patient with a very large lesion
  • No patient had tumor invasion into the surrounding muscle or bony thorax, or pleural effusion
  • No tumors recurred during follow-up of 4 months to 6 years (average 24 months)
• The authors' conclusion: The authors concluded that their experience suggests intense enhancement of the tumors occurs because of the tumors' vascularity

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, CT Scan, Parenchyma, Pleural Effusion.

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• Localized mesotheliomas of the pleura. The pathologic evaluation of 18 cases — E.A. Foster, L.V. Ackerman (1960)

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