[Asbestosis accompanied by primary peritoneal mesothelioma]

Diffuse, continuous abdominal pain and weight loss of 10 kg in 3 months were observed in a 57-year-old female patient. A CT examination of the abdomen was requested to rule out a malignant gynecological tumor. The CT study, however, showed a small amount of ascites and a thick sheet-like mass covering the internal anterior abdominal wall. On the basis of these CT findings, a peritoneal mesothelioma was suspected, which was confirmed by diagnostic laparotomy. The patient's history revealed exposure to asbestos at work from 21 to 24 years of age. The following signs of asbestosis and asbestos-related pleural disease were observed in the chest X-ray film: small opacities in the lower zones of both lungs, diffuse pleural thickening, a plaque on the right diaphragm, and small bilateral pleural effusions. In cases of suspected occupational illness such as that presented here, each physician concerned including the radiologist involved in the diagnosis, is required to advise the social insurance institution responsible.