CT findings of hypervascular malignant peritoneal mesothelioma

Our plain-English summary of CT findings of hypervascular malignant peritoneal mesothelioma, by D.S. Granke, J.H. Ellis, B.D. Richmond (Computerized Radiology, 1987).

The study

• Authors: D.S. Granke, J.H. Ellis, B.D. Richmond
• Journal: Computerized Radiology
• Published: 1987;11(2):91-4
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of peritoneal mesothelioma is presented in which CT demonstrated abnormal regions of increased vascularity in the omentum corresponding to hypervascular omental lesions shown by angiography. This CT appearance has not been described in prior reports of CT in peritoneal mesothelioma.

In plain English

This article was a case report about one patient with malignant peritoneal mesothelioma, a cancer of the lining of the abdomen, and how it looked on imaging. The patient was a 54-year-old white man with a 3-month history of abdominal tenderness, feeling full early, bloating and crampy abdominal pain. An angiogram, an X-ray of blood vessels, showed an enlarged artery and enlarged branches supplying several areas with abnormally many blood vessels in the omentum, a fatty fold of tissue in the abdomen. A later CT scan showed fluid in the abdomen and abnormally increased small vessels in the omentum. Tests on abdominal fluid were consistent with mesothelioma. Fluid around the right lung also tested positive, and Stage III mesothelioma was diagnosed. The patient had no known history of asbestos exposure. The authors did not expect this CT appearance to be specific to peritoneal mesothelioma, because other conditions, such as recent surgery, trauma or inflammation, could cause similar changes. They suggested that the disease may be diagnosed earlier when the radiologist suggests it.

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: case report
• Who was studied: One patient: a 54-year-old white male with abdominal symptoms. No place or date for the case is stated beyond the authors' Veterans Administration and University of Michigan affiliations in Ann Arbor.
• Exposure: No asbestos exposure was identified; the patient had no known history of asbestos exposure. No fiber types or jobs are described.
• Main results:
  • The angiogram showed a hypertrophied right gastroepiploic artery and enlarged epiploic branches supplying several hypervascular lesions in the omentum.
  • The later CT showed ascites (abdominal fluid) and abnormally increased small vessels in the omentum, matching the hypervascular regions seen on the angiogram.
  • According to the authors, the major CT findings were subtle regions of increased vascularity in the omentum.
  • A stellate (star-shaped) mesenteric pattern was suggested on two CT images.
  • Cytology of the peritoneal fluid, using microscopic and electron microscopic techniques, was consistent with mesothelioma.
  • Chest X-ray showed a right pleural effusion, and the pleural fluid cytology was also positive.
  • With disease above and below the diaphragm, Stage III mesothelioma was diagnosed.
• The authors' conclusion: The authors concluded that earlier diagnosis of peritoneal mesothelioma may result when the radiologist suggests the diagnosis, because special stains and electron microscopy are needed to confirm it.
• Limitations the authors state:
  • The authors did not expect the CT appearance of increased omental vascularity to be specific for peritoneal mesothelioma. Changes in omental fat could also occur with recent surgery, trauma, inflammation, or vascular or lymphatic obstruction.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Omentum.

Related studies

• Peritoneal mesothelioma: CT and MRI findings — M. Puvaneswary, S. Chen, et al. (2002)
• Deciduoid peritoneal mesothelioma: CT findings with pathologic correlation — D.J. Chung, Y.W. Kang, et al. (2003)
• Symptoms, signs and radiologic findings in patients having reoperative surgery for malignant peritoneal mesothelioma — M.D. Llanos, P.H. Sugarbaker (2017)
• Peritoneal mesothelioma: the role of computed tomography in diagnosis and follow up — P.J. Guest, R.H. Reznek, et al. (1992)
• CT differentiation of diffuse malignant peritoneal mesothelioma and peritoneal carcinomatosis — Y.F. Liang, G.Q. Zheng, et al. (2016)
• Concerning CT features predict outcome of treatment in patients with malignant peritoneal mesothelioma — P.H. Sugarbaker, D. Chang, et al. (2021)

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