Rounded atelectasis and mesothelioma

Our plain-English summary of Rounded atelectasis and mesothelioma, by R.F. Munden, H.I. Libshitz (AJR. American Journal of Roentgenology, 1998).

The study

• Authors: R.F. Munden, H.I. Libshitz
• Journal: AJR. American Journal of Roentgenology
• Published: 1998;170(6):1519-22
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: The purpose of this article is to report the coexistence of rounded atelectasis with malignant pleural mesothelioma as revealed by radiography and CT.

Conclusion: Our five cases show the coexistence of rounded atelectasis and malignant mesothelioma. If rounded atelectasis is associated with a pleural effusion, a pleural mass with or without chest-wall invasion, or thickened pleura not adjacent to the rounded atelectasis, malignant mesothelioma should be strongly considered.

In plain English

This report described five patients at The University of Texas M.D. Anderson Cancer Center in whom rounded atelectasis, a folded, collapsed area of lung that can look like a mass, appeared alongside malignant pleural mesothelioma on chest radiographs and CT scans. The five, one of them previously published, came from 391 patients with malignant pleural mesothelioma examined over 10 years. All were men aged 46 to 65 whose mesothelioma was confirmed by tissue examination; only one had documented asbestos exposure. In every patient the rounded atelectasis was on the same side as the mesothelioma, and the masses measured 2 to 6.5 cm. Three patients had fluid around the lung (pleural effusion). In two, the atelectasis was not next to the thickest pleural disease. Two had a pleural mass invading the chest wall. The authors concluded that mesothelioma should be strongly considered when rounded atelectasis comes with a pleural effusion, a pleural mass, or thickened pleura not next to it. They also said a lung mass in a mesothelioma patient may be rounded atelectasis rather than cancer.

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 series (report of five cases reviewed by radiography and CT), including one previously published case
• Who was studied: Five men aged 46, 47, 58, 60 and 65, all with histologically documented mesothelioma, drawn from 391 patients with malignant pleural mesothelioma examined over a 10-year period at the authors' institution (Department of Radiology, The University of Texas M.D. Anderson Cancer Center, Houston)
• Exposure: Only one of the five patients had documented asbestos exposure; no fiber types, products, jobs or doses were reported
• Main results:
  • In all five patients, rounded atelectasis was on the same side as the malignant pleural mesothelioma (three in the left lower lobe, one in the right lower lobe, one in the right upper lobe)
  • The five masses of rounded atelectasis measured 2, 2.5, 3, 6 and 6.5 cm
  • Three of the five cases had a coexisting pleural effusion: one large malignant effusion and two with small areas of pleural fluid
  • In two of the five cases, the rounded atelectasis was not adjacent to the thickest area of pleural disease, unlike the usual pattern in benign pleural disease
  • The patient with the 2.5-cm rounded atelectasis had an adjacent pleural mass invading the chest wall
  • The previously reported patient with the 6-cm mass had chest-wall invasion with rib destruction
  • The authors noted that in a patient with mesothelioma and a lung mass, the lung mass may be rounded atelectasis rather than a malignancy
• The authors' conclusion: The authors concluded that if rounded atelectasis is associated with a pleural effusion, a pleural mass with or without chest-wall invasion, or thickened pleura not adjacent to the rounded atelectasis, malignant mesothelioma should be strongly considered
• Limitations the authors state:
  • No follow-up was available for two of the five masses (the 3-cm and 6.5-cm masses)

Topics

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

Medical terms in this study, explained in our Lexicon: Rounded Atelectasis, Mesothelioma, Pleural Mesothelioma, Malignant Mesothelioma, Pleural Effusion, Pleura.

Related studies

• Rounded atelectasis due to acute exudative effusion. Spontaneous resolution — L.S. Smith, R.F. Schillaci (1984)
• An unusual case of rounded atelectasis — G. Geremia, R.A. Mintzer (1984)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Rounded atelectasis of the lung — G.T. Stathopoulos, M.T. Karamessini, et al. (2005)
• Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases — C. Voisin, F. Fisekci, et al. (1995)
• Rounded atelectasis associated with pulmonary lymphangioleiomyomatosis — K. Kishi, S. Homma, et al. (2005)

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