CTICasesPleural Mesothelioma
Imaging findings
Chest radiography shows a right-sided subpulmonic pleural effusion and mild thickening of the minor fissure. High-resolution contrast-enhanced CT of the chest, performed in the pulmonary arterial phase, demonstrates a right pleural effusion along with extensive nodular thickening studding the minor fissure and subtle nodularity of the mediastinal pleura.
Key takeaways
Pleural mesothelioma can present primarily as a subpulmonic effusion with nodular thickening of the fissures, which may be easily overlooked on CT. It is essential to carefully inspect the fissures for nodular pleural disease in patients presenting with unexplained or bloody pleural effusions. Late contrast-enhanced CT phases are preferred for pleural evaluation, as standard pulmonary embolism protocols may not allow adequate pleural enhancement.
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