Imaging findings of malignant pleural mesothelioma
The most common chest radiographic finding of malignant pleural mesothelioma is a loculated pleural effusion. Unilateral pleural masses and plaquelike or nodular, irregular pleural thickening with encasement of the entire lung are also common findings that are highly suggestive of mesothelioma. Extension into the interlobar fissures, lung, mediastinum, chest wall, diaphragm, and biopsy tracts may occur. As a result of constriction of the lung by adherent pleural tumor, ipsilateral volume loss of the hemithorax with ipsilateral mediastinal shift, narrowing of the intercostal spaces, and elevation of the ipsilateral hemidiaphragm are commonly present. Pleural calcification resulting from prior asbestos exposure is seen in two thirds of cases, and intrathoracic lymphadenopathy, extension to the peritoneum or retroperitoneum, and hematogenous metastases anywhere in body may be seen on CT or MRI in later stages. Increased FDG uptake is commonly observed on 18 F-fluorodeoxyglucose positron emission tomography (FDG PET)
