Pleural Neoplasms

Pleural neoplasms discusses the radiographic and computed tomography (CT) manifestations of primary and secondary pleural neoplasms. Four CT features suggest malignant pleural thickening including nodular pleural thickening, circumferential pleural thickening, pleural thickening measuring greater than 1 cm in thicknesss, and thickening of the mediastinal pleural surface. The most common pleural malignancy is metastatic disease, generally from adenocarcinomas of the lung, breast, or gastrointestinal tract. Thymoma may spread to the pleura via direct extension or drop metastases. Mesothelioma is uncommon but is the most common primary pleural malignancy and is almost universally associated with asbestos exposure. It manifests with rind-like pleural thickening which may involve interlobar fissures and often causes volume loss in the affected hemithorax. Localized fibrous tumor of the pleura usually arises from the visceral pleural surface and manifests as a lobular or smooth pleural mass usually in the mid or lower hemithorax.