Malignant mesothelioma is an uncommon and fatal neoplasm of the pleura.
Asbestos exposure is found in about half of all patients with diffuse malignant mesothelioma.
The interval between first exposure to asbestos and presentation with the tumor is in the order of 20 to 40 years.
The peak age at presentation is between 40 and 70 years, with male predominating.
Imaging findings are essentially similar on chest radiographs, CT, and MRI.
Imaging findings typically consist of extensive nodular or lobular thickening of the pleura, which may conglomerate to
form a circumferential lobular sheet of soft tissue density encasing the lungs.
The tumor often runs into the fissures accompanied by varying amount of pleural effusions. Invasion of chest wall,
adjacent lung, pericardium, other mediastinal structures, and diaphragm usually occur relatively late.
Lymphatic and hematogenous metastases are usually late manifestations.
The differential diagnosis includes pleural involvement by other malignant tumors as well as benign conditions such
as asbestos-related benign pleural effusion, asbestos-related pleural plaque, tuberculous pleural thickening, and
empyema.
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