Mesothelioma CT
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Mesothelioma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Mesothelioma CT On the Web |
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American Roentgen Ray Society Images of Mesothelioma CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
CT Scan
- CT is the most commonly used modality for the assessment of mesothelioma and is able to stage the disease accurately in most patients.
- The appearance is that of a soft tissue attenuation nodular mass which spreads along pleural surfaces including into pleural fissures and often creating a pleural rind.
- Calcification is seen in 20% of cases which usually represents engulfed calcified pleural plaques rather than true tumour calcification.
- Sarcomatoid variants may demonstrate osteosarcoma or chondrosarcomatous components which may also be calcified.
- An uncommon variant is the solitary mediastinal malignant mesothelioma which has appearances reminiscent of a solitary fibrous tumour of the pleura.
- Mesotheliomas have a predilection for direct invasion of adjacent structures (chest wall, diaphragm and mediastinal content) but also frequently metastasise to the contralateral lung and local nodes.
- To confidently predict chest wall invasion the extrapleural fat plane should be seen to be infiltrated and/or direct extension in bone or muscle identified.
- Presence of a pericardial effusion suggests transpericardial extension.