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1、AFIPARCHIVES259BestCasesfromtheAFIPMalignantMesothelioma1SeanM.Tyszko,MD●GaryD.Marano,MD●RobertJ.Tallaksen,Editor’sNote.Every-onewhohastakentheMD●KymberlyA.Gyure,MDcourseinradiologicpa-thologyattheArmedForcesInstituteofPa-thology(AFIP)remem-Historybersbringingbeauti
2、fullyA58-year-oldmanwhohadworkedonasbestos-linedfurnaces40yearsagoillustratedcasesforac-presentedtohisphysicianwithahistoryofmultipleepisodesofexertionaldys-cessiontotheInstitute.Inrecentyears,thestaffpneaoverthepastyear.Overthepast6months,thepatienthadthreepleuralo
3、ftheDepartmentofeffusionsdrainedontheleftsidewithunremarkableresultsatcytologicanalysis.RadiologicPathologyHealsoreportedweightlossofabout10lb(4.5kg)overtheprevious46hasjudgedthebestmonths.Physicalexaminationdemonstrateddecreasedbreathsoundsonthecasesbyorgansystem,a
4、ndrecognitionisgivenleftsidewithdullnesstopercussion.Laboratorydatawereunremarkable.tothewinnersonthelastdayoftheclass.WitheachImagingFindingsissueofRadioGraphics,Initialchestradiographyandchestcomputedtomography(CT)demonstratedoneormoreofthesecasesarepublished,circ
5、umferential,lobulatedpleuralthickeninginvolvingtheleftlungwithassoci-writtenbythewinningatedleftlungvolumeloss(Figs1,2).Whole-bodyintegratedpositronemissionresident.Radiologic-tomography(PET)CTdemonstratedcircumferentialpleuralthickeningsur-pathologiccorrelationisem
6、phasized,andtheroundingtheentireleftlungwithsignificanthypermetabolicglucoseactivitycausesoftheimagingconsistentwithtumor.PET-CTalsoshowedhypermetabolictumorfociinvad-signsofvariousdiseasesingthepulmonaryparenchyma.Noevidenceofchestwallormediastinalinva-areillustrate
7、d.sionwasseenandnodistantmetastaseswereidentified(Fig3).RadioGraphics2007;27:259264●Publishedonline10.1148/rg.271065105●ContentCodes:1FromtheDepartmentsofRadiology(S.M.T.,G.D.M.,R.J.T.)andPathology(K.A.G.),WestVirginiaUniversity,1MedicalCenterDr,Room2278,Box9235,Morg
8、antown,WV26506.ReceivedMay25,2006;revisionrequestedJune14andreceivedJune27;acceptedJune28.Allauthorshavenofinancialrelationshipstodisclose.
