Friday, April 29, 2011

Pleural Masses

Multiple

  • Pleural metastases: Case shown above (Ewing sarcoma)
  • Asbestos related pleural disease: Look for calcifications.
  • Malignant mesothelioma: Diffuse nodular pleural thickening, thicker at lung bases, with a small hemithorax and pleural effusion. Grows along fissures.
  • Invasive thymoma: Pleural metastases rare, but well-described.
  • Lymphoma: Look for other enlarged nodes.
  • Splenosis: Left-sided pleural thickening in a patient with history of distant trauma and an absent spleen.

Solitary

  • Pleural metastases:
  • Solitary fibrous tumor of the pleura: Hypervascular mobile mass displacing rather than invading adjacent structures. No chest wall involvement. Calcifications are more common in malignant lesions, but malignant and benign tumors are indistinguishable on imaging.
  • Lipoma: Like solitary fibrous tumors of the pleura, pleural lipmas may also be pedunculated and mobile.
  • Malignant mesothelioma:

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