Engelhard K, Rödl W
Radiologe. 1985 Feb;25(2):60-5.
From 1972 and 1982 we observed 6 cases of diffuse pleural mesothelioma and 3 cases of peritoneal mesothelioma in the Department of Internal Medicine of the University of Erlangen-Nürnberg. In 5 of 6 cases one sided noncharacteristic relapsing pleural effusion was the only sign of the pleural tumor process. Only in one case a pleural tumor constallation was diagnosed. Tomography of the lung showed a normal free central bronchial system and peripheral bronchial infiltration or displacement. In all cases CT scans were able to localize the tumor furthermore to demonstrate the exact extension and the infiltration of the mediastinum or of the diaphragm into the abdomen. Beside conventional x-rays such as double contrast examination of the colon and mesenterial angiography CT scans played the major role in diagnosing this rare peritoneal mesothelioma. Massive ascites, mesenterial infiltration, thickening of the mesenterial radix, and tumor embedding of bowel and vessels is of diagnostic significance. To ensure the diagnosis one has to do a thoraco- or laparoscopy.