Value of computed tomography in the evaluation of pleural diseases

ABSTRACT

48 cases of localised and diffuse pleural diseases were evaluated with computerized tomography [CT] after perforimg plain X-ray chest [both P.A. and Lat. Views]. History of asbestos exposure was obtained in 12% of the cases, while past history of radiotherapy was found in 27% of the cases. Plain X-ray chest revealed unilateral opacification in 41 cases and bilateral opacification in 7 cases. The opacity was homogenous in 20 cases, heterogenous in 27 cases and nodular in 5 cases. Ipsilateral mediastinal shift was seen in 41 cases. CT revealed 25 cases with solid masses [17 cases associated with pleural effusion] and 23 cases with pleural effusion [free effusion in 20 cases and encysted in 3 cases]. Mediastinal lymphadenopathy was found in 5 cases [3 cases of proven lymphoma and 2 cases of pleural metastasis from cancer breast]. Diaphragmatic invasion and retroperitoneal extension of mesothelioma were found in 2 cases. Liver metastasis was detected in 2 cases. CT guided fine-needle aspiration biopsy [FNAB] was done in 25 cases, thoracotomy and wide resection of pleural mass was performed in 4 cases. CT could differentiate solid lesion from pleural effusion, clearly demonstrate extension of the lesion, associated lymphadenopathy, rib destruction, distant liver metastasis in addition to taking CT guided FNAB