Presentation
Chest pain and left pleural effusion.
Patient Data
Age: 65 years
Gender: Male
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Coronal PET images
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.
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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