Mesothelioma Diagnosis Diagnostic Imaging 3

Question 1

Which radiologic sign on chest X-ray suggests mesothelioma has encased and contracted the affected hemithorax?

Accepted Answer

Ipsilateral volume loss with pleural thickening

Answer

Mesothelioma often causes ipsilateral volume loss because the tumor encases and constricts the lung, rather than pushing the mediastinum to the opposite side.

Question 2

CT-guided core needle biopsy of a pleural mass in suspected mesothelioma is preferred over fine needle aspiration (FNA) because:

Accepted Answer

It provides tissue architecture needed for subtyping

Answer

Core needle biopsy preserves tissue architecture, which is essential for immunohistochemical subtyping (epithelioid vs. sarcomatoid) of mesothelioma.

Question 3

Which nuclear medicine finding on PET scan is associated with higher-grade or sarcomatoid mesothelioma?

Accepted Answer

High SUV (standardized uptake value)

Answer

High FDG uptake (high SUV) on PET correlates with more aggressive tumor biology, including sarcomatoid differentiation and worse prognosis.

Question 4

Pleural plaques seen on CT are important in mesothelioma diagnosis because they indicate:

Accepted Answer

Prior asbestos exposure

Answer

Calcified pleural plaques are a marker of prior asbestos exposure and, while benign themselves, raise suspicion for asbestos-related malignancy.

Question 5

In peritoneal mesothelioma, which CT feature best predicts completeness of cytoreductive surgery?

Accepted Answer

Peritoneal cancer index (PCI) score

Answer

A low PCI score on preoperative CT predicts that complete cytoreduction is achievable, which is the strongest predictor of long-term survival.

Mesothelioma Diagnosis Practice Test

Mesothelioma Diagnosis Practice Test

Mesothelioma Diagnosis Diagnostic Imaging 3