The aim of our study was to evaluate CT features which are helpful in differentiating malignant pleural mesothelioma and metastasis of the pleura. We evaluated CT findings of histopathologically proved 7 cases of mesothelioma and 15 cases of
metastasis
retrospectively. The scans were assessed for unilaterality, plural rind, hilar lymphadenopathy, mediastinal pleura involvement, calcification, pleural effusion, loss of volume, most pronounced lesion area according to trisected hemithorax and
prominent
nodularity.
Unilaterality was seen in 6 cases (86%) of mesothelioma, 13 cases (87%) of metastasis. Pleural rind was seen in 6 cases (86%) of mesothelioma, 9 cases (60%) of metastasis. Hilar lymphadenopathy was seen in 1 case (14%) of mesothelioma, 4 cases
(26%).
Mediastinal pleural involvement was seen in 6 cases (86%) of mesothelioma, 14 cases (93%) of metastasis. Pleural calcification was seen in 2 cases (29%) in mesothelioma, 2 cases (13%) in metastasis. Pleural effusion was seen in 5 cases (71%) of
mesothelioma, 13 cases (87%) of metastasis. Loss of volume was seen in 4 cases (57%) of mesothelioma, 10 cases (67%) in metastasis. Mesotheliomas show most pronounced pleural lesion in lower hemithorax in 5 cases (71%), whereas 1 case (7%) in
metastasis. Prominent nodularity was more commonly found in metastasis (mesothelioma=29%, metastasis=80%).
In the majority of patients, mesothelioma could not be distinguished from metastasis on CT. However, the tendency of mesothelioma to involve the lower hemithorax and the presence of prominent nodularity in metastasis may be helpful CT findings in
differentiation of both disease.
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