title: Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea.
abstract: To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD).
  
  
  
  The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque.
  
  
  
  Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD.
  
  
  
  Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.
authors.affiliation: Department of Radiology, Gachon University Gil Medical Center, Incheon 21565, Korea.
authors.forename: Yoon Kyung
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Dongguk University Ilsan Hospital, Goyang 10326, Korea.
authors.forename: Jeung Sook
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
authors.forename: Chin A
authors.initials: CA
authors.lastname: Yi
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
authors.affiliation: Department of Pathology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea.
authors.forename: Soon-Hee
authors.initials: SH
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016017:Odds Ratio; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: CT; Mesothelioma; Metastasis; Pleura