285.Malignant Mesothelioma（2）（恶性间皮瘤）

每天朗读一段医学影像学英语文章

Imaging Findings

On chest radiograph, the lesion usually appears as a markedly thickened, nodular, irregular pleural based mass which coats the pleural surface and grows along fissures. The tumor often encircles the involved lung and is only rarely bilateral. Chest wall, diaphragmatic, and mediastinal invasion can be seen with more advanced disease. A moderate to large ipsilateral pleural effusion is seen. Because mesothelioma encases the lung, it may fix the affected hemithorax so there may not be mediastinal shift of the contralateral hemithorax, in fact there may be evidence of volume loss on the affected side even in the presence of massive effusion.

Common findings on CT include a unilateral pleural effusion, nodular pleural thickening, and interlobar fissure thickening. Mediastinal pleural involvement is also seen. The absence of pleural thickening does not exclude malignancy. Irregularity of the interface between the chest wall and the tumor is not a reliable indicator of chest wall invasion. Transdiaphragmatic extension include a soft tissue mass invading the hemidiaphragm, while a clear fat plane between the diaphragm and adjacent abdominal organs and a smooth diaphragmatic contour indicate the tumor is confined to the thorax.

     Diagnosis is made based on thoracoscopically-guided biopsy. Treatment includes surgical resection for limited disease, radiation therapy, and chemotherapy.

Notes：

1. Mesothelioma [ˌmesˌmezəˌθi:li:'oʊmə] n. 间皮瘤

2. pleural ['plʊərə] adj. 胸腔; 胸膜的

3. fissure [ˈfɪʃɚ] n. 裂

4. mediastinal [ˌmi:dɪæs'taɪnəl] 纵隔的

5. ipsilateral [ɪpsɪ'lætərəl] adj. 身体的同侧的

6. hemithorax [hemɪ'θɔ:ræks] n. 半侧胸廓

7. interlobar [ɪntə'loʊbə] adj. 叶间的

8. Transdiaphragmatic [trænzdaɪəfræɡ'mætɪk] 经横膈的

9. thorax [ˈθɔrˌæks, ˈθor-] n. 胸

10. thoracoscopically 胸腔镜

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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