Dynamic contrast enhancement of asbestos-related pulmonary pseudotumours

Our plain-English summary of Dynamic contrast enhancement of asbestos-related pulmonary pseudotumours, by P.M. Taylor (The British Journal of Radiology, 1988).

The study

• Author: P.M. Taylor
• Journal: The British Journal of Radiology
• Published: 1988;61(731):1070-2
• Type of article: Case report
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This report described three men with asbestos-related pulmonary pseudotumour (round atelectasis), seen at the Department of Diagnostic Radiology, University of Manchester, and examined the effect of intravenous contrast on their computed tomography (CT) appearances, which had not previously been recorded. All three had a history of asbestos exposure and pleural thickening. Each had a homogeneous, well-defined soft-tissue mass 3 to 3.5 cm in diameter beside thickened pleura, with lung vessels curving towards the lesion. Sections were repeated with dynamic contrast enhancement using 100 ml meglumine iothalamate. Mean attenuation rose from 35 to 100 Hounsfield units (HU) in a 48-year-old electrician, from 35 to 92 HU in a 56-year-old man, and from 40 to 65 HU in a 73-year-old maintenance fitter. In the first patient, thoracotomy found very thick parietal pleura but no folded lung or palpable mass. In the second, needle biopsy showed cellular fibrosis without malignancy, and the lesion was unchanged over 6 years. The third did not undergo thoracotomy. The lesions met six of eight published CT criteria for rounded atelectasis. Adjacent pleural thickening did not enhance significantly. The author concluded that these lesions enhance with contrast despite their fibrous nature, so enhancement did not help distinguish them from bronchial carcinoma, although it did help separate pleural from pulmonary lesions. Differentiation from malignant disease should instead rely on the CT criteria of Doyle and Lawler.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a case report from a university radiology department in Manchester. It described three men with asbestos-related pulmonary pseudotumour (round atelectasis), a rounded lung mass next to thickened pleura. The author recorded how the masses changed on CT scans after intravenous contrast dye. Case 1 was a 48-year-old electrician with light asbestos exposure 30 years earlier. His 3 cm mass rose from 35 to 100 Hounsfield units. Surgery, however, found very thick pleura and no folded lung, and no mass could be felt in the underlying lung. Case 2 was a 56-year-old man with intermittent asbestos exposure from 1955 to 1980. His biopsy showed fibrosis without cancer, and his mass rose from 35 to 92 units. Case 3 was a 73-year-old who removed asbestos pipe lagging for 30 years. His mass rose from 40 to 65 units and was not operated on. The nearby pleural thickening did not enhance significantly. The author concluded that contrast did not help tell these lesions from bronchial carcinoma and that criteria published by other researchers should be used instead.

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 (three cases)
• Who was studied: Three men aged 48, 56 and 73 with lung masses studied by CT, described by the author from a Department of Diagnostic Radiology, University of Manchester. Scans and events in the 1980s (case 2 chest radiograph 1981 and CT 1987; case 3 presented 1984 and was rescanned two years later).
• Exposure: Asbestos, fiber type not stated. Case 1: an electrician with intermittent light exposure to asbestos sheets 30 years earlier, who never cut sheets (he also smoked 30 cigarettes a day). Case 2: intermittent asbestos exposure between 1955 and 1980. Case 3: 30 years as a maintenance fitter removing asbestos lagging from pipes, and occasional work with laggers replacing asbestos.
• Main results:
  • Case 1: the right upper lobe mass had a mean pre-contrast value of 35 HU and enhanced to a mean of 100 HU.
  • Case 1: at thoracotomy there was very thick parietal pleura, but no folded lung and no palpable mass in the underlying lung. Lung tissue showed no fibrosis and no asbestos bodies, and the pleural appearances were thought to be a chronic inflammatory lesion.
  • Case 2: needle biopsy of the mass showed cellular fibrosis with no malignancy, and the lesion was unchanged on chest radiographs over 6 years.
  • Case 2: the 3 cm mass rose from 35 HU to 92 HU after dynamic contrast enhancement.
  • Case 3: the 3.5 cm right mid-zone mass enhanced from 40 to 65 HU. No thoracotomy was performed, and the author judged the features almost certainly those of an asbestos-related pulmonary pseudotumour.
  • All three patients met six of the eight CT features described by Doyle and Lawler (1984). None had air bronchograms or increased density at the edge of the mass.
  • The adjacent pleural thickening showed no significant enhancement, so contrast helped separate the pleural lesions from the lung lesions.
• The authors' conclusion: The author concluded that these lesions do enhance with contrast despite their fibrous nature, so contrast does not help distinguish them from bronchial carcinoma. In the author's view, distinction from malignant disease should be made using the CT criteria proposed by Doyle and Lawler (1984).

Topics

Medical terms in this study, explained in our Lexicon: Atelectasis, Asbestos Exposure, Pleural Thickening, Pleura, Thoracotomy, Parietal Pleura, Rounded Atelectasis, Needle Biopsy.

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• Screening for asbestos-related pleural disease with digital storage phosphor radiography — C.M. Schaefer, R. Greene, et al. (1990)
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