Malignant Pleural Mesothelioma with Osteoblastic Heterologous Elements
CT and MR Imaging Findings
Géraldine Chave1,
Lara Chalabreysse2,
Georges Picaud1,
Nadine Blineau1,
Robert Loire2,
Françoise Thivolet2,
Yves Berthezène1,
C. Philippe Douek3 and
Bruno Marchand1
1
Department of Radiology, Hôpital de la Croix-Rousse, 103 Grande Rue de
la Croix-Rousse, 69317 Lyon Cedex, France.
2
Department of Pathology, Hôpital Cardiovasculaire et Pneumologique Louis
Pradel, 28 Ave. Doyen Lépine, 69500 Bron-France.
3
Department of Radiology, Hôpital Cardiovasculaire et Pneumologique Louis
Pradel, 69500 Bron-France.
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Fig. 1A. —59-year-old man with malignant pleural mesothelioma with
osteoblastic heterologous elements. Initial unenhanced CT scan (lung window
setting) shows right focalized pleural thickening (long arrow) with
no calcification. Air (short arrow) in pleural thickening is related
to prior puncture.
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Fig. 1B. —59-year-old man with malignant pleural mesothelioma with
osteoblastic heterologous elements. Photomicrograph of initial histologic
specimen obtained from pleural biopsy using thoracoscopy shows biphasic
pleural tumor with epithelial component (arrowhead) intermingled with
spindle cells (arrow). (H and E, x40)
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Fig. 1C. —59-year-old man with malignant pleural mesothelioma with
osteoblastic heterologous elements. Unenhanced CT scan (mediastinal window
setting), obtained 3 years later at same level as A, shows increase in
pleural thickening spreading into chest wall (arrow) associated with
two coarse calcifications (arrowheads) that were situated close to
mediastinal pleura and into right paratracheal space. These calcifications may
be due to direct tumoral extension, because of their continuity with mass,
although it is not possible to formally exclude enlarged calcified lymph node
in region 4R.
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Fig. 1D. —59-year-old man with malignant pleural mesothelioma with
osteoblastic heterologous elements. Unenhanced axial T1-weighted MR image
displays chest wall and apical extension by tumor (arrow) and pleural
calcifications with no signal (arrowheads).
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Fig. 1E. —59-year-old man with malignant pleural mesothelioma with
osteoblastic heterologous elements. Unenhanced coronal short tau
inversion-recovery MR image reveals calcified areas with no signal
(arrow) and remainder of tumor with bright signal
(arrowhead) spreading into chest wall and lung apex.
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Fig. 1F. —59-year-old man with malignant pleural mesothelioma with
osteoblastic heterologous elements. Photomicrograph of histologic specimen
obtained from pleural biopsy 3 years after B reveals highly malignant
proliferation of poorly differentiated tumoral cells of epithelioid type with
osteoid tissue (arrowhead). (H and E, x25)
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Copyright © 2002 by the American Roentgen Ray Society.
