title: Fatal pleural mesothelioma in Japan (2003-2008): evaluation of computed tomography findings.
abstract: OBJECTIVE
  The purpose of this study was to clarify the characteristic findings of mesothelioma at the time of diagnosis, and determine precautions and guidelines for diagnosing mesothelioma early in imaging studies.
  
  
  METHODS
  Overall, 327 patients with pleural mesothelioma were selected from 6030 patients who died of mesothelioma between 2003 and 2008 in Japan. Their imaging findings were examined retrospectively.
  
  
  RESULTS
  Plaques were found in 35 % of computed tomography (CT) scans. Asbestosis, diffuse pleural thickening, and rounded atelectasis were found in only seven (2 %), five (2 %), and two cases (1 %), respectively. Pleural thickening findings on CT scans were classified into four stages: no irregularity, mild irregularity, high irregularity, and mass formation. Overall, 18 % of cases did not show a clear irregularity. Localized thickening was observed in the mediastinal (77 %) and basal (76 %) pleura and in the interlobar fissure (49 %). Eight percent of cases did not have any thickening in these three areas.
  
  
  CONCLUSIONS
  Upon examination of the CT scans at diagnosis, 18 % of mesothelioma cases did not show a clear irregularity. When diagnosing pleural effusion of unknown etiology, it is necessary to consider the possibility of mesothelioma even when no plaque and pleural irregularity are observed.
authors.affiliation: Department of Radiology, Okayama University Hospital, 2-1-1 Shikatacho, Okayama, 7008558, Japan. kato-rad@med.kawasaki-m.ac.jp.|Department of Diagnostic Radiology 2, Kawasaki Medical School, 2-1-80 Nakasange, Kita-ku, Okayama, 7008505, Japan. kato-rad@med.kawasaki-m.ac.jp.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Medical Oncology, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan.|Department of Respiratory Medicine, Chugoku Chuo Hospital, 148-13 Miyukicho Oaza Kamiiwanari, Fukuyama, 7200001, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Gemba
authors.affiliation: Department of Medical Oncology, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: Department of Medical Oncology, National Hospital Organization Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, 7550241, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aoe
authors.affiliation: Department of Pathology, Hiroshima University Graduate School of Medicine, 1-2-3 Kasumi, Hiroshima, 7340037, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Takeshima
authors.affiliation: Department of Pathology, Hiroshima University Graduate School of Medicine, 1-2-3 Kasumi, Hiroshima, 7340037, Japan.|Pathologic Diagnostic Center, Inc., 11-28 Hacchobori, Naka-ku, Hiroshima, 7300013, Japan.
authors.forename: Kouki
authors.initials: K
authors.lastname: Inai
authors.affiliation: Department of Internal Medicine, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kishimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging* / Q000401:mortality*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Computed tomography; Japan; Mesothelioma