Malignant Pleural Mesothelioma

Radiologic-Pathologic Correlation

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

Introduction

Malignant pleural mesothelioma (MPM) is the most common primary neoplasm of the pleura, but it is still rare in the general population of the United States, where its incidence in male patients ranges from seven to 13 new cases per million persons per year (1). The incidence in the occupationally unexposed population of North America is approximately one to two cases per million persons per year (1). In some asbestos-exposed groups, more than 10% of workers may die of MPM (2).

MPM is a tumor of insidious onset that is characterized by unilateral pleural effusion and pleural nodules, masses, and plaquelike growth with invasion of the fissures and encasement of the lung; these features result in a characteristic radiologic appearance. Diagnostic problems arise for the pathologist in the differentiation of MPM from adenocarcinoma, asbestos-related pleural fibrosis, and reactive pleural hyperplasia. Radiologic studies including plain radiography, computed tomography (CT), and magnetic resonance (MR) imaging are helpful in determining the diagnosis and staging of the tumor. It remains unclear whether treatment alters the relentless progression to death seen in the vast majority of patients.

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