Yilmaz U M, Utkaner G, Yalniz E, Kumcuoglu Z
Izmir Chest Disease and Surgery Hospital, Turkey.
Respirology. 1998 Mar;3(1):33-8. doi: 10.1046/j.1440-1843.1998.00069.x.
Malignant pleural mesothelioma (MPM) is not an infrequent fatal neoplasm. It is endemically present in some regions of Turkey due to its aetiological relationship to exposure to environmental fibrous minerals. The aim of this study was to determine the thorax computed tomographic (CT) features of environmental asbestos-related MPM. In this study, we examined retrospectively the CT scans of 46 untreated patients with pathological diagnosis of environmental asbestos-related MPM among 151 patients with malignant pleural mesothelioma in the Izmir Chest Disease and Surgery Hospital. The CT scans were interpreted by consultation of four observers. Malignant pleural mesothelioma was unilateral in 45 (97.2%) of the patients. Pleural effusions were found in 42 (91%) of the patients, pleural calcifications in 12 (26%), contracted hemithorax in 14 (30%), interlobar fissure involvement in 25 (54%) and mediastinal pleural involvement in 26 (57%). A contracted hemithorax was significantly correlated with pleural rind configuration. Pleural thickenings were found in 45 (99%) of the patients. Pleural thickenings were in the form of nodularity in 10 (22%) cases, regular in 12 (27%) cases, as a focal mass in 3 (7%) cases and as a pleural rind in 20 (44%) cases. Pleural thickening was greater than 1 cm in 32 (71%) cases. The most common CT findings in our series were unilateral circumferential pleural thickening, nodular pleural thickening, pleural thickening greater than 1 cm and mediastinal pleural involvement. Generally, pleural effusion was accompanied by this. There was interlobar fissure involvement in half of the patients. There was no pathognomonic CT finding in environmental asbestos-related MPM. But CT was useful in suggesting the diagnosis of malignant pleural disease in the cases with MPM.
恶性胸膜间皮瘤（MPM）是一种常见的致命性肿瘤。由于其与环境纤维矿物质暴露的病因学关系，在土耳其的一些地区呈地方性流行。本研究的目的是确定环境石棉相关MPM的胸部计算机断层扫描（CT）特征。在本研究中，我们回顾性分析了伊兹密尔胸科疾病与外科医院151例恶性胸膜间皮瘤患者中46例未经治疗且经病理诊断为环境石棉相关MPM患者的CT扫描结果。CT扫描由四名观察者会诊解读。45例（97.2%）患者的MPM为单侧性。42例（91%）患者发现胸腔积液，12例（26%）有胸膜钙化，14例（30%）有患侧胸廓塌陷，25例（54%）有叶间裂受累，26例（57%）有纵隔胸膜受累。患侧胸廓塌陷与胸膜增厚表现显著相关。45例（99%）患者发现胸膜增厚。胸膜增厚表现为结节状10例（22%），规则形12例（27%），局灶性肿块3例（7%），胸膜增厚表现3例（7%），胸膜增厚表现为胸膜增厚20例（44%）。32例（71%）患者胸膜增厚大于1cm。我们系列研究中最常见的CT表现为单侧环形胸膜增厚、结节状胸膜增厚、胸膜增厚大于1cm和纵隔胸膜受累。一般来说，胸腔积液与之并存。半数患者有叶间裂受累。在环境石棉相关MPM中没有特异性的CT表现。但CT有助于提示MPM患者恶性胸膜疾病的诊断。
