RadioGraphics: May 1, 1996 -- Volume 16, Number 3

Malignant Pleural Mesothelioma
Radiologic-Pathologic Correlation

Barbara H. Miller, MD (Retired) Melissa L. Rosado-de-Christenson, Lt Col, USAF, MC Andrew C. Mason, MD Marian V. Fleming, JD, MD Charles C. White, MD Mark J. Krasna, MD.

Abstract Introduction Etiology and Epidemiology of MPM Clinical Features Microscopic Features Characterization of MPM with Histochemistry, Immunochemistry, and Electron Microscopy

Gross Pathologic Characteristics Radiographic Features CT Features MR Imaging Findings Differential Diagnosis

Diagnostic Methods Staging and Resectability Treatment Prognosis Source Information References

Abstract

Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm that typically affects individuals occupationally exposed to asbestos through a variety of industries. The patients experience an insidious onset of symptoms, including dyspnea, chest pain, cough, malaise, and weight loss. The pathologic diagnosis of MPM is difficult, and special stains or immunohistochemical or ultrastructural analysis may be required to differentiate MPM from metastatic adenocarcinoma. The tumor affects both the parietal and visceral pleural surfaces and progresses to encase the lung and invade the lung, mediastinum, and chest wall. Radiologically, MPM manifests as unilateral pleural effusion, pleural nodules, or pleural masses. Imaging studies are useful for diagnosis and staging in patients who are potential surgical candidates. Although a variety of multimodality therapies are available and radical surgical procedures have been developed, the prognosis remains dismal.