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Haseli S, Mansoori B, Shafiei M, Shomal Zadeh F, Chalian H, Khoshpouri P, Yousem D, Chalian M. A Review of Posteromedial Lesions of the Chest Wall: What Should a Chest Radiologist Know? Diagnostics (Basel) 2022; 12:diagnostics12020301. [PMID: 35204391 PMCID: PMC8871555 DOI: 10.3390/diagnostics12020301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 12/10/2022] Open
Abstract
A heterogeneous group of tumors can affect the posteromedial chest wall. They form diverse groups of benign and malignant (primary or secondary) pathologies that can arise from different chest wall structures, i.e., fat, muscular, vascular, osseous, or neurogenic tissues. Chest radiography is very nonspecific for the characterization of chest wall lesions. The modality of choice for the initial assessment of the chest wall lesions is computed tomography (CT). More advanced cross-sectional modalities such as magnetic resonance imaging (MRI) and positron emission tomography (PET) with fluorodeoxyglucose are usually used for further characterization, staging, treatment response, and assessment of recurrence. A systematic approach based on age, clinical history, and radiologic findings is required for correct diagnosis. It is essential for radiologists to be familiar with the spectrum of lesions that might affect the posteromedial chest wall and their characteristic imaging features. Although the imaging findings of these tumors can be nonspecific, cross-sectional imaging helps to limit the differential diagnosis and determine the further diagnostic investigation (e.g., image-guided biopsy). Specific imaging findings, e.g., location, mineralization, enhancement pattern, and local invasion, occasionally allow a particular diagnosis. This article reviews the posteromedial chest wall anatomy and different pathologies. We provide a combination of location and imaging features of each pathology. We will also explore the role of imaging and its strengths and limitations for diagnosing posteromedial chest wall lesions.
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Affiliation(s)
- Sara Haseli
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA 98105, USA; (S.H.); (M.S.); (F.S.Z.); (P.K.)
| | - Bahar Mansoori
- Department of Radiology, Division of Abdominal Imaging, University of Washington, Seattle, WA 98105, USA;
| | - Mehrzad Shafiei
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA 98105, USA; (S.H.); (M.S.); (F.S.Z.); (P.K.)
| | - Firoozeh Shomal Zadeh
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA 98105, USA; (S.H.); (M.S.); (F.S.Z.); (P.K.)
| | - Hamid Chalian
- Department of Radiology, Division of Cardiothoracic Imaging, University of Washington, Seattle, WA 98105, USA;
| | - Parisa Khoshpouri
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA 98105, USA; (S.H.); (M.S.); (F.S.Z.); (P.K.)
| | - David Yousem
- Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD 21287, USA;
| | - Majid Chalian
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA 98105, USA; (S.H.); (M.S.); (F.S.Z.); (P.K.)
- Correspondence: ; Tel.: +1+(206)-598-2405
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Malignant Pleural Mesothelioma: Are There Imaging Characteristics Associated With Different Histologic Subtypes on Computed Tomography? J Comput Assist Tomogr 2018; 42:601-606. [PMID: 29613986 DOI: 10.1097/rct.0000000000000727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Determine imaging characteristics specific to epithelioid (eMPM), sarcomatoid (sMPM), and biphasic (bMPM) subtypes of malignant pleural mesothelioma (MPM) on computed tomography. METHODS Preoperative computed tomography scans of patients with MPM were retrospectively assessed for numerous features including primary affected side, volume loss, pleural thickness, pleural calcifications, pleural effusion, and lymphadenopathy. RESULTS One hundred twenty-five patients with MPM were included. Histologic subdivision was 97 eMPM (77%), 17 bMPM (14%), and 11 sMPM (9%). Nonepithelioid MPM (bMPM and sMPM) was more likely than eMPM to have calcified pleural plaques (P = 0.035). Analyzed separately, bMPM and sMPM each demonstrated calcified plaques more frequently than eMPM, and sMPM more often had internal mammary nodes; however, P values did not reach significance (P = 0.075 and 0.071, respectively). CONCLUSIONS Calcified plaques are significantly more common in nonepithelioid subtypes compared with eMPM. Given the different prognoses and management of MPM subtypes, accurate noninvasive subtype classification is clinically vital.
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Subramaniam RM, Wilcox B, Aubry MC, Jett J, Peller PJ. 18F-fluoro-2-deoxy-D-glucose positron emission tomography and positron emission tomography/computed tomography imaging of malignant pleural mesothelioma. J Med Imaging Radiat Oncol 2009; 53:160-9; quiz 170. [DOI: 10.1111/j.1754-9485.2009.02058.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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