Radiological manifestations of malignant pleural mesothelioma

Our plain-English summary of Radiological manifestations of malignant pleural mesothelioma, by V.W. Au, M. Thomas (Australasian Radiology, 2003).

The study

• Authors: V.W. Au, M. Thomas
• Journal: Australasian Radiology
• Published: 2003;47(2):111-6
• Type of article: Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma has had a rising incidence in Australia over the past 40 years. This pictorial essay gives a brief account of the condition, summarizes the various radiological manifestations and aims at increasing the awareness of a disease that is expected to reach its peak incidence in the early decades of the twenty-first century.

In plain English

This article was a pictorial essay, an illustrated review, from Flinders Medical Centre in Adelaide, Australia. It did not report a new study. It summarized how malignant pleural mesothelioma appears on chest X-ray, CT, MRI and PET scans. It drew on earlier published case series and showed images from seven patients, all men aged 55 to 82. Citing those series, the authors reported that pleural thickening was the most common CT finding, seen in 92–94% of cases, with pleural effusion (fluid around the lung) in 72–76%. Pleural calcification was seen in 12–62% of cases, and spread to mediastinal lymph nodes at first presentation in 34–58%. Earlier work had found CT and MRI nearly equivalent for staging, and the authors said the roles of MRI and PET were not yet established. Citing the Australian Mesothelioma Register, they gave 1999 incidence rates of 53 per million for men and 10 per million for women. The authors concluded that no radiological feature is unique to the disease, but that radiologists should be aware of these features.

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 essay (illustrated narrative review) summarizing published imaging findings, with example images from individual patients; not an original study
• Who was studied: No study population. Images and brief case descriptions of seven illustrative patients, all men aged 55 to 82, mostly from Flinders Medical Centre, Adelaide (one PET image courtesy of Royal Adelaide Hospital). Figures from the literature come from earlier published CT case series.
• Exposure: Exposure was not studied. The essay describes asbestos exposure in general terms as the main risk factor and names erionite in certain regions; no fiber types are named. One illustrated patient had a known history of asbestos exposure.
• Main results:
  • Citing earlier CT series (not this article's own data), pleural thickening was the most common CT finding of malignant pleural mesothelioma, in 92–94% of cases, and was associated with pleural effusion in 72–76% of cases.
  • Citing earlier series, pleural calcification was variably seen, in 12–62% of cases.
  • Citing earlier series, metastasis to mediastinal lymph nodes on initial presentation was seen in 34–58% of cases.
  • Earlier work found CT and MRI nearly equivalent in staging accuracy. The authors stated that the role of MRI was yet to be established and that the role of PET was under evaluation.
  • Citing the Australian Mesothelioma Register, the 1999 incidence rate of malignant mesothelioma in Australia was 53 per million for men and 10 per million for women.
• The authors' conclusion: The authors concluded that although characteristic radiological features have been described, none is pathognomonic (unique to) malignant pleural mesothelioma. They said reporting radiologists should be aware of these features and, in the appropriate clinical context, be able to make the diagnosis.

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.

Related studies

• Recurrent malignant peritoneal mesothelioma: radiological manifestations — F.F. Souza, J. Jagganathan, et al. (2010)
• The radiological manifestations of malignant pleural mesothelioma — R.M. Heller, M.L. Janower, et al. (1970)
• The radiological investigation of the early manifestations of exposure to asbestos dust — F.A. Mackenzie (1971)
• Lymphangitic carcinomatosis: A common radiographic manifestation of local failure following extended pleurectomy/decortication in patients with malignant pleural mesothelioma — I. Berger, K.A. Cengel, et al. (2019)
• Malignant pleural mesothelioma: CT manifestations in 50 cases — A. Kawashima, H.I. Libshitz (1990)
• Asbestos-related focal lung masses: manifestations on conventional and high-resolution CT scans — D.A. Lynch, G. Gamsu, et al. (1988)

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