Imaging Features of Various Benign and Malignant Tumors and Tumorlike Conditions of the Pleura: A Pictorial Review

Our plain-English summary of Imaging Features of Various Benign and Malignant Tumors and Tumorlike Conditions of the Pleura: A Pictorial Review, by J.Y. Bae, Y. Kim, H.J. Kang, et al (Taehan Yŏngsang Ŭihakhoe Chi, 2020).

The study

• Authors: J.Y. Bae, Y. Kim, H.J. Kang, H. Kwon, S.S. Shim
• Journal: Taehan Yŏngsang Ŭihakhoe Chi
• Published: 2020;81(5):1109-1120
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural masses may be caused by various conditions, including benign and malignant neoplasms and non-neoplastic tumorlike conditions. Primary pleural neoplasms include solitary fibrous tumor, malignant mesothelioma, and primary pleural non-Hodgkin's lymphoma. Metastatic disease is the most common neoplasm of the pleura and may uncommonly occur in patients with hematologic malignancy, including lymphoma, leukemia, and multiple myeloma. Pleural effusion is usually associated with pleural malignancy. Rarely, pleural malignancy may arise from chronic empyema, and the most common cell type is non-Hodgkin's lymphoma (pyothorax-associated lymphoma). Non-neoplastic pleural masses may be observed in several benign conditions, including tuberculosis, pleural plaques caused by asbestos exposure, and pleural loose body. Herein, we present a review of benign and malignant pleural neoplasms and tumorlike conditions with illustrations of their computed tomographic images.

Copyrights © 2020 The Korean Society of Radiology.

In plain English

This article is a pictorial review by authors from the Department of Radiology at Ewha Womans University College of Medicine in Seoul, Korea. Using chest X-ray and CT images from individual patients, it described how benign and malignant pleural tumors and tumorlike conditions look on imaging. It did not describe a systematic study or say how the illustrated cases were chosen. Citing earlier published work, the authors wrote that malignant pleural mesothelioma is associated with asbestos exposure. Its most typical CT findings, they wrote, are unilateral pleural effusion, pleural thickening or mass, and interlobar fissure thickening, and calcified pleural plaques are noted in some cases. They described pleural plaques as the most common pleuropulmonary abnormality associated with asbestos exposure. Plaques are considered a marker of exposure that indicates an increased risk of mesothelioma, lung cancer and asbestosis. One figure showed a 63-year-old man with asbestos-related pleural plaques and malignant mesothelioma of the peritoneum. The review also covered solitary fibrous tumor, lymphoma, metastasis, leukemia, multiple myeloma, cancers arising from chronic empyema, tuberculosis and pleural loose bodies. The main text did not discuss asbestos fiber types.

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: Pictorial review (pictorial essay) of imaging features, illustrated with CT and chest radiograph images of individual patients; it does not describe a systematic study
• Who was studied: Individual patients whose images illustrate each condition, for example a 63-year-old man with asbestos-related pleural plaques and peritoneal mesothelioma, and patients aged 60, 71 and 63 with malignant mesothelioma. The article does not give the number of patients, how they were selected, or when they were imaged.
• Exposure: In the main text, asbestos exposure is discussed in general terms, in connection with malignant mesothelioma and pleural plaques. The main text gives no fiber types, products, jobs or doses. The reference cited for the plaque-risk statement is a cohort study of vermiculite miners exposed to tremolite.
• Main results:
  • Citing earlier literature, the review described the most typical CT findings of malignant pleural mesothelioma as unilateral pleural effusion, pleural thickening or mass, and interlobar fissure thickening.
  • In some cases of malignant pleural mesothelioma, calcified pleural plaques representing asbestos-related disease are noted.
  • Citing earlier literature, the review described pleural plaques as considered a marker of asbestos exposure that indicates an increased risk of mesothelioma, lung cancer and asbestosis.
  • Pleural plaques usually appear on CT as bilateral and multiple, along the chest wall, diaphragm and mediastinum; the costophrenic angles are generally spared.
  • One illustrated patient, a 63-year-old man, had bilateral multiple calcified pleural plaques and malignant mesothelioma of the peritoneum, confirmed on peritoneal biopsy.
  • Citing earlier work, the review stated that pleural metastasis shows metastatic lymph nodes or metastatic lung nodules more often than malignant mesothelioma does, although pleural thickening has no distinguishing CT features.
• The authors' conclusion: The article has no conclusion section. The authors stated that their aim was to present common pleural diseases with their typical radiologic findings.

Topics

Medical terms in this study, explained in our Lexicon: Pleura, Neoplasm, Solitary Fibrous Tumor, Malignant Mesothelioma, Myeloma, Pleural Effusion, Empyema, Pleural Plaques.

Related studies

• Focal pleural tumorlike conditions: nodules and masses beyond mesotheliomas and metastasis — M.C. de Paula, D.L. Escuissato, et al. (2015)
• Benign fibrous mesothelioma of the pleura: MR imaging findings — G.N. Harris, A. Rozenshtein, et al. (1995)
• From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation — A.D. Levy, J. Arnáiz, et al. (2008)
• Primary malignant tumors of peritoneal and retroperitoneal origin: clinical and imaging features — M.G. Lubner, J.L. Hinshaw, et al. (2014)
• Cytopathological features of solitary fibrous tumor of the pleura: a study of 5 cases — B. Weynand, P. Collard, et al. (1998)
• Benign localized fibrous tumor of the pleura: report of 25 new cases — S. Enon, D. Kilic, et al. (2012)

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