Pericardial Mesothelioma,
Pericardial Effusion & Pericardial Masses
Pericardial Mesothelioma
Pericardial Mesothelioma
is a tumor that can occur at any age with a mean age of 46 years at presentation.
Patients present with chest pain, dyspnea, cough, and palpitations. Although
there appears to be a strong link to asbestos exposure, a definite association
has not been established due to the rarity of this lesion.Surgery combined
with radiation therapy may provide some palliation, but the prognosis
is extremely poor. On CT there is irregular, diffuse pericardial thickening
and a pericardial effusion. Pericardium is a thin lining of tissue surrounding
the heart.
Pericardial Effusion
Pericardial effusion is the collection
of fluid in the sac that surrounds the heart, a possible sign of cancer
as well as many other conditions. When it is caused by cancer, it can
be result of either direct spread of cancer from adjacent organs like
the lung, or by metastatic spread from other parts of the body.
Pericardial Masses
The most common primary mass is a congenital
celomic cyst. Benign and malignant pericardial solid masses are equally
common. Teratoma and malignant mesothelioma are the leading primary solid
masses. Secondary malignancies are far more common than primary with seventy
percent due to spread from lung, breast and lymphoproliferative disorders.
Although primary tumors more commonly affect the myocardium than the pericardium
the reverse is true of secondary tumors. In those with pericardial metastases
25% have reduced cardiac function and for the majority tamponade is the
commonest cause of death.
CT features of masses that may elucidate their etiology include;morphology,
location, extent, cyst or solid character, their effect on cardiac chambers
as well as their enhancement characteristics and the amount of extracardiac
disease. It is in the setting of malignancy with its ability to evaluate
the whole thorax that CT has much to offer.
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PERICARDIAL MESOTHELIOMA - CASE
STUDY
Primary pericardial mesothelioma:
Yuko Kobayashi1, , Ryusuke Murakami1, Junko Ogura1, Kanae Yamamoto1, Taro
Ichikawa1, Kouichi Nagasawa2, Masaru Hosone3 and Tatsuo Kumazaki4(1) Department of Radiology, Tama-Nagayama
Hospital, Nippon Medical School, 1-7-1 Nagayama, Tama-shi, Tokyo 206-8512,
Japan
(2) Department of Internal Medicine, Tama-Nagayama Hospital, Nippon Medical
School, 1-7-1 Nagayama, Tama-shi, Tokyo 206-8512, Japan
(3) Department of Pathology, Tama-Nagayama Hospital, Nippon Medical School,
1-7-1 Nagayama, Tama-shi, Tokyo 206-8512, Japan
(4) Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku,
Tokyo 113-8603, Japan
Abstract. The imaging features of primary pericardial mesothelioma have
rarely been described. Herein we present a case report of its diagnostic-pathologic
features. Chest computed tomography (CT) revealed an irregularly enhanced
mass occupying the entire pericardial space and surrounding the superior
vena cava. At autopsy, the tumor was found to fill the pericardial space
completely, and to extend to the superior vena cava through the superior
pericardial sinus. The CT features of the tumor were correlated well with
those revealed at autopsy, and provided satisfactory information regarding
the presence and the extension of the tumor.
See:
http://link.springer.de/link/service/journals/00330/contents/01/00884/
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