
Article in Japanese
A case of malignant mesothelioma that required a differential diagnosis from inflammatory pleural thickening
Satoko Shimadua Norio Yoshidab Akira Matsuib Masaru Iwatab Takeshi Yamadac Yoshinori Hasegawaa
aDepartment of Respiratory Medicine, Nagoya University Graduate School of Medicine
bDepartment of Respiratory and Allergy Medicine, Kariya Toyota General Hospital
cDepartment of General Thoracic Surgery, Kariya Toyota General Hospital
A 56-year-old man was referred to our hospital for an abnormal chest X-ray shadow. He had no apparent experience of occupational exposure to asbestos. A chest computed tomography (CT) scan revealed irregular pleural thickening and no pleural effusion in the right thoracic cavity. Positron-emission tomography with 18F-fluorodeoxyglucose (FDG-PET)/CT scan on admission showed no significant FDG accumulation on the thickened pleura. The pleural biopsy was done surgically, and the histopathological diagnosis of the resected specimen was a mixed-type malignant pleural mesothelioma. A right extrapleural pneumonectomy was performed and followed by chemotherapy using cisplatin combined with pemetrexed. Malignant mesothelioma generally shows pleural thickening and pleural effusion in a CT scan and FDG uptake in FDG-PET/CT. We reported here a case of pleural thickening with false-negative PET images and no pleural effusion that requires a surgical pleural biopsy for the differential diagnosis of malignant mesothelioma from inflammatory pleural thickening.
Malignant pleural mesothelioma Inflammatory pleural thickening Positron-emission tomography with 18F-fluorodeoxyglucose Surgical pleural biopsy
Received 2 Sep 2011 / Accepted 3 Jul 2012
AJRS, 2(1): 3-7, 2013