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The Egyptian Journal of Bronchology
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Correlation between computed tomography of the chest and medical thoracoscopic findings in primary pleural tumors

Egyptian Journal of Bronchology volume 8, pages 32–37 (2014)Cite this article

Abstract

Background

Malignant pleural mesothelioma ( MPM) is an aggressive tumor arising from the mesothelial cells lining the pleura. It commonly presents with unilateral pleural effusion with variable degree of pleural thickening and nodularity. MPM usually develops on the parietal pleura, and involvement of the visceral pleura indicates more advanced stage. Treatment of MPM should not be started before correct diagnosis and staging with computed tomography (CT) and thoracoscopy.

Aim of the study

The aim of this study was to assess the correlation between findings on chest CT and those on thoracoscopy and to evaluate the sensitivity of chest CT to identify malignant pleural lesions.

Patients and methods

Patients with suspected MPM and indicated for medical thoracoscopy for diagnostic confirmation were enrolled in the present study. Twenty patients with confirmed diagnosis after tissue biopsies with medical thoracoscopy were selected. Comparison and correlation between CT findings and medical thoracoscopic findings were made.

Results

Thoracoscopy showed parietal pleural invasion in all patients, whereas noncontrast chest CT showed parietal pleural lesions in 14 patients (70%). Visceral pleural involvement was evident in 13 patients (65%) on thoracoscopy, but chest CT detected only one case (5%) with visceral pleural involvement. Three patients (15%) were found to have fibrous septations on thoracoscopy, compared with only one patient (5%) on chest CT. The sensitivity of noncontrast chest CT in the detection of MPM was 70%.

Conclusion

Although the sensitivity of noncontrast chest CT in the detection of MPM is high, thoracoscopy is needed not only to confirm the diagnosis but also to assess the different parts of the pleura and to allow proper staging of the disease. Egypt J Broncho 2014 8:32–37

References

  1. Robinson BW, Musk AW, Lake RA. Malignant mesothelioma. Lancet 2005; 366:397–408.

    Article  CAS  Google Scholar 

  2. Boutin C, Rey F, Gouvernet J, Viallat JR, Astoul Ph, Ledoray V. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Cancer 1993; 72:394–404.

    Article  CAS  Google Scholar 

  3. Metintas M, Ucgun I, Elbek O, Erginel S, Metintas S, Kolsuz M, et al. Computed tomography features in malignant pleural mesothelioma and other commonly seen pleural diseases. Eur J Radiol 2002; 41:1–9.

    Article  Google Scholar 

  4. Leung AN, Muller NL, Miller RR. CT in differential diagnosis of diffuse pleural disease. Am J Roentgenol 1990; 154:487–492.

    Article  CAS  Google Scholar 

  5. Benamore RE, Scott K, Richards CJ, Entwisle JJ. Image guided pleural biopsy: Diagnostic yield and complications. Clin Radiol 2006; 61:700–705.

    Article  CAS  Google Scholar 

  6. Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC. World Health Organization Classification of Tumours. Pathology and genetics. Tumours of the lung, pleura, thymus and heart. Cancer Res 2004; 55:792–798.

    Google Scholar 

  7. Metintas M, Guntulu Ak, Dundar E, Yildirim H, Ozkan R, Kurt E, et al. Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions. Chest 2010; 137:1362–1368.

    Article  Google Scholar 

  8. Bergonzini R, Olivetti L, Tassi GF, Chiodera PL. Malignant mesothelioma of the pleura, correlations between thoracoscopy and radiology. Radiol Med 1996; 92:52–57.

    CAS  PubMed  Google Scholar 

  9. Chrysanthidis MG, Janssen JP. Autofluorescence videothoracoscopy in exudative pleural effusions: a preliminary study. Eur Respir J 2005; 26:989–992.

    Article  CAS  Google Scholar 

  10. Prosst RI, Winkler S, Boehm E, Gahlen J. Thoracoscopic fluorescence in diagnosis of pleural malignancies. Thorax 2002; 57:1005–1009.

    Article  CAS  Google Scholar 

  11. Viallat JR, Boutin C, Rey F, Gouvernet J, Astoul Ph, Ledoray V. Malignant mesothelioma, study of prognostic factors in a series of 188 cases. Arch Anat Cytol Pathol 1993; 41:205–211.

    CAS  PubMed  Google Scholar 

  12. Maasilta P, Vehmas T, Kivisaari L, Tammilehto L, Mattson K. Correlations between findings at computed tomography (CT) and at thoracoscopy/ thoracotomy/autopsy in pleural mesothelioma. Eur Respir J 1991; 4:952–954.

    CAS  PubMed  Google Scholar 

  13. Mason AC, Miller BH, Krasna MJ, White CS. Accuracy of CT for the detection of pleural adhesions correlation with video-assisted thoracoscopic surgery. Chest 1999; 115:423–427.

    Article  CAS  Google Scholar 

  14. Yilmaz U, Polat G, Sahin N, Yilmaz U, Polat G, Sahin N, et al. CT in differential diagnosis of benign and malignant pleural disease. Monaldi Arch Chest Dis 2005; 63:17–22.

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Chest Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Tarek Safwat, Samar Sharkawy & Amr Shoukri MD

  2. Chest Department, Abbassia Chest Hospital, 11341, Cairo, Egypt

    Suzan Mohamed

Authors
  1. Tarek Safwat
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  2. Samar Sharkawy
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  3. Amr Shoukri MD
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  4. Suzan Mohamed
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Corresponding author

Correspondence to Amr Shoukri MD.

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Safwat, T., Sharkawy, S., Shoukri, A. et al. Correlation between computed tomography of the chest and medical thoracoscopic findings in primary pleural tumors. Egypt J Bronchol 8, 32–37 (2014). https://doi.org/10.4103/1687-8426.137349

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  • DOI: https://doi.org/10.4103/1687-8426.137349

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