Pleural mesothelioma

Case contributed by Dalia Ibrahim


Chest pain and left pleural effusion.

Patient Data

Age: 65 years
Gender: Male



FDG avid left pleural circumferential nonuniform sheet and mass-like thickening involving the costal, mediastinal and diaphragmatic pleura, with SUV max 12 and measuring cm in max thickness. The mass invades the pericardium and encases the descending thoracic aorta. It also shows diagrammatic invasion and lower lateral chest wall invasion.

Associated left hydropneumothorax.

No distant metastasis.


Pleural biopsy revealed mesothelioma.

Case Discussion

PET- CT is useful in pleural mesothelioma in two clinical settings

  • differentiating between benign and malignant asbestos-related pleural thickening
  • assessing for nodal or distant metastases

There is a correlation between the degree of FDG uptake and the biological aggressiveness of the tumor, which may help to guide treatment.

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