Nodular thickening of interlobar fissures: an early manifestation of malignant mesothelioma: A case report

Two men with occupational exposure to asbestos were admitted to our hospita l with minute pleural changes on their chest CT image. Conventional compute d tomography (CT) scans of the chest showed slightly thickened interlobar f issures and a small amount of pleural effusion. In addition, high-resolutio n CT showed small nodular opacities on interlobar fissures. There were no i ntrapulmonary mass shadows, pleural plaques or other extrapulmonary mass sh adows. These roentgenographical findings were very similar to each other. H yarulonic acid values obtained from their pleural fluid were extremely high . Finally, we diagnosed them as having malignant mesothelioma using an immu nocytochemical technique and electronmicroscopy, We conclude that HRCT is h elpful in the diagnosis of malignant mesothelioma, particularly in its earl y manifestation such as nodular opacities of interlobar fissures.