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THE RADIOLOGICAL MANIFESTATIONS OF MALIGNANT PLEURAL MESOTHELIOMA

RICHARD M. HELLER M.D.1, MURRAY L. JANOWER M.D.2, and ALFRED L. WEBER M.D.3

1 Resident in Radiology, Massachusetts General Hospital. Presently at Children's Hospital Medical Center.
2 Instructor in Radiology, Harvard Medical School; Assistant Radiologist, Massachusetts General Hospital.
3 Clinical Associate in Radiology, Harvard Medical School; Associate Radiologist, Massachusetts General Hospital.

Pleural mesothelioma is a frequent enough tumor to be considered in the differential diagnosis of chest tumors. The most characteristic symptoms are pain and dyspnea. A history of asbestos exposure or pulmonary asbestosis should alert the radiologist to the possibility of an existing or developing pleural mesothelioma.

The important radiologic manifestations are: (1) pleural effusion, often recurrent; (2) irregular, nodular pleural thickening, with or without bone destruction; and (3) a nodular density, frequently in the peripheral portion of the lung.

The prognosis is poor. Of the 10 patients studied, 7 died; 2 are alive but have persistent disease; and 1 patient, with a small nodular lesion, is cured 44 months following surgery.


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