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Weekly Chest CasesArchive of Old Cases

Case No : 1201 Date 2020-10-27

  • Courtesy of Yeonjung Jang, Soyeoun Lim, Woon-Jung Kwon / Ulsan University Hospital
  • Age/Sex 43 / F
  • Chief Complaintcough for 1 month and mild left chest discomfort
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Malignant mesothelioma
Radiologic Findings
Figure 1. Radiograph shows two large pleural based masses in the left lower hemithorax.
Figure 2. Chest CT scans show multiple, variable sized, heterogeneously enhancing pleura-based masses involving left side pleural space.
Brief Review
Malignant pleural mesothelioma is uncommon aggressive malignant tumor of the mesothelium. It is the most common primary malignant neoplasm of the pleura. It usually occurs after 50 years of age and tends to develop in men. This is mostly associated with prior asbestos exposure and occurs 20-40 years after exposure to asbestos. The industries with the highest risk of mesothelioma are construction and ship repair, asbestos industry, and manufacture of metal construction materials. Other risk factors include environmental factors, genetic factors and radiation. The mean age at diagnosis is 63 years. Symptoms may include dyspnea, chest pain, cough, and weight loss. CT is the primary imaging modality used to evaluate malignant mesothelioma. CT findings of malignant mesothelioma include nodular pleural thickening, interlobar fissure thickening, pleural effusion, ipsilateral mediastinal shift, pleural calcification, and invasion into the chest wall. Mediastinal lymph node metastases can be observed in half. The prognosis is poor and median survival time is about 12 months after diagnosis.
Please refer to
Case 144, Case 155, Case 335, Case 551, Case 623, Case 726, Case 788, Case 813, Case 815, Case 835, Case 934, Case 968, Case 1006,
KSTR Imaging Conference 2005 Spring  Case 8 ,
KSTR imaging conference cases 2010 Sprng  Case 2 ,
KSTR imaging conference 2018 Summer  Case 8,
References
1. Malignant Pleural Mesothelioma: Evaluation with CT, MR Imaging, and PET, RadioGraphics 2004; 24:105–119
2. Muller’s imaging of the chest, Elsevier, p1008-1021
3. 흉부영상의학, 일조각, 604-606
Keywords
pleura, mesothelioma, malignant mesothelioma,

No. of Applicants : 69

▶ Correct Answer : 12/69,  17.4%
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - Primus , India ABHISHEK BHASKAR YASHOD
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - , Japan HIROAKI ARAKAWA
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Ichinomiya Nishi Hospital , Japan CHIHIRO KIGUCHI
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Private sector , Greece VASILIOS TZILAS
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - IRSA LA ROCHELLE , France JEAN LUC BIGOT
▶ Correct Answer as Differential Diagnosis : 36/69,  52.2%
  • - Other , Korea (South) KYU-CHONG LEE
  • - Lilavati Hospital , India DHRUV UMESH SHARMA
  • - Mayo Clinic , Japan HIROAKI TAKAHASHI
  • - Cabinet Capricorne, clinique sainte-clotilde , Reunion FABIEN HO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - McGill University Health Center , Canada Alexandre Semionov
  • - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
  • - Jiangsu province hospital , China WANGJIAN ZHA
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - The University of Tokyo Hospital , Japan MOTO NAKAYA
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - GEMS, Srikakulam, Andhra Pradesh , India RAMU C
  • - Chonbuk National University Hospital , Korea (South) YOUNG JU SONG
  • - Chonbuk National University Hospital , Korea (South) MINJEE KIM
  • - Chonbuk National University Hospital , Korea (South) YOUNGKWANG LEE
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Chungbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - TB centre kasaragod. , India rikhy krishnan
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Kitano Hospital , Japan SATOSHI IKEDA
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - , Japan HIROAKI ARAKAWA
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