Korean Journal of Radiology

  • 제17권4호
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  • Pages.545-553
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  • 2016
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea

  • Kim, Yoon Kyung (Department of Radiology, Gachon University Gil Medical Center) ;
  • Kim, Jeung Sook (Department of Radiology, Dongguk University Ilsan Hospital) ;
  • Lee, Kyung Won (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Yi, Chin A (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Koo, Jin Mo (Department of Radiology, Seoul National University College of Medicine) ;
  • Jung, Soon-Hee (Department of Pathology, Yonsei University Wonju College of Medicine)
  • 투고 : 2015.12.07
  • 심사 : 2016.04.21
  • 발행 : 2016.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). Materials and Methods: The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. Results: Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. Conclusion: Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.

키워드

과제정보

연구 과제 주관 기관 : Korean Ministry of the Environment

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  2. Migrating pleural plaque in a patient with asbestos induced pleural disease: a case report vol.12, pp.None, 2016, https://doi.org/10.1186/s12995-017-0171-8
  3. Atypical Presentation of T-Cell Large Granular Lymphocytic Leukemia Mimicking Pleural Malignancy on 18F-FDG PET/CT vol.44, pp.4, 2019, https://doi.org/10.1097/rlu.0000000000002425