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: