Malignant pleural mesothelioma: The spectrum of manifestations on CT in 70cases

AIM: The aim of this pictorial review is to illustrate the spectrum of mani festations on computed tomography (CT) of malignant pleural mesothelioma, M alignant pleural mesothelioma is the most common primary neoplasm of the pl eura, but nevertheless is a rare tumour, It has a strong association with p revious occupational exposure to asbestos and has a bleak prognosis, MATERIALS AND METHODS: The pre-treatment CT findings of 70 patients at our institution, and the subsequent findings of the 35 patients who had follow- up CT, have been reviewed by three observers by consensus. 16 patients had surgical resections, RESULTS: The most common pre-treatment findings were pleural thickening (94 %) and pleural effusions (76%), Both contraction (27%) and enlargement (10% ) of the ipsilateral hemithorax were identified, Extension of disease to th e chest wall, mediastinum, thoracic lymph nodes, and below the diaphragm we re identified, Concurrent bilateral pleural calcification and plaques indic ative of previous asbestos exposure were identified in 16% of patients, CT failed to identify chest wall and mediastinal invasion in a number of patie nts who underwent surgical resections, CONCLUSION: CT plays an important role in the diagnosis, assessment, and ev aluation of treatment response of this tumour, although it has some limitat ions in specific areas in evaluating patients for surgical resection.