Tumor and tumorlike conditions of the pleura and juxtapleural region: review of imaging findings

Abstract

Pleural lesions form a diagnostic challenge for the radiologist. Whereas lesions can be initially detected on chest radiographs, CT and MRI imaging are the imaging modalities of choice for further characterization. In a number of cases, imaging findings can be relatively specific. In general unfortunately, imaging findings are rather aspecific. Evolution and extrathoracic imaging findings are important clues toward the diagnosis.

Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study

“…The reported radiological findings of primary SCC in 2 case reports were single pleural nodule with no signs of invasion [14] , bilateral pleural effusion and irregular thickening with involvement of fissures and pericardium, as well as mediastinal lymphadenopathy [15] . Other pleural etiologies considered rare from various literature include pleural lipoma, pleural splenosis, pleural pseudotumor, desmoplastic small round cell tumor, pleural involvement of Erdheim-Chester disease, diffuse pulmonary lymphangiomatosis, synovial sarcoma, solitary fibrous tumor, lymphoma, thymoma, and amyloidosis [ 1 – 3 , 5 , 6 ].…”

“…Pleural diseases compose a wide range of pathology from benign to malignant, primary or secondary, which may appear with various appearances, whether solitary or diffuse, with multiple involvements. The most common primary malignancy in pleura is mesothelioma, while the metastatic process is the most recurrent secondary malignancy [1] . Both mesothelioma and metastatic process constitute the major proportion of malignancy cases in pleura, with the metastatic process being far more frequent than mesothelioma [ 2 , 3 ].…”

“…It is reported that the estimated annual incidence of mesothelioma is 10.000 across Western Europe, Scandinavia, North America, Japan, and Australia. Among the said regions, every country reports various incidence rates, from 1.0/100.000 in the United States to 4.2/100.000 in the United Kingdom [ 1 , 5 ].…”

“…Radiology plays a pivotal role in the diagnosis of pleural tumors. The chest X-ray is usually the first modality for patients with thoracic complaints [1] . In patients with malignancy suspicion, one of the primary steps is to determine whether the mass is located intrapulmonary, extrapulmonary, or pleural.…”

“…Pleural effusion is the most occurring secondary finding [4] and can be readily visible when a significant volume of fluid is present. Chest CT scan is a cross-sectional imaging modality often used to visualize the lesion further and characterize its relationship with adjacent organs [1] . From a CT scan, radiological appearances of pleural diseases, such as focal or diffuse pleural thickening, pleural plaque, and calcification, can be better depicted.…”