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Related Experiment Videos

Malignancy associated with chronic empyema: radiologic assessment.

M Minami1, N Kawauchi, K Yoshikawa

  • 1Department of Radiology, University of Tokyo Hospital, Japan.

Radiology
|February 1, 1991
PubMed
Summary

Radiologists should suspect malignancy in chronic empyema cases, as imaging may reveal subtle signs. Early detection through advanced imaging and biopsy is crucial for these rare but serious conditions.

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Area of Science:

  • Thoracic Radiology
  • Oncology
  • Pulmonology

Background:

  • Chronic empyema, a persistent pleural infection, can rarely be associated with thoracic malignancies.
  • Distinguishing malignancy from benign changes in chronic empyema poses a diagnostic challenge.

Purpose of the Study:

  • To review radiologic findings in patients with malignancy secondary to chronic empyema.
  • To highlight key imaging features that suggest malignancy in this context.

Main Methods:

  • Retrospective review of radiologic findings (plain radiographs, CT, MRI, scintigraphy, ultrasound) in six pathologically confirmed cases of malignancy associated with chronic empyema.
  • Pathologic confirmation included B-cell non-Hodgkin lymphomas, round-cell sarcoma, mesothelioma, and adenocarcinoma.

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Main Results:

  • Radiographic signs included increased opacity, chest wall abnormalities, bone destruction, and pleural calcification deviation.
  • CT provided clearer delineation of soft-tissue masses.
  • MRI showed characteristic low-intensity rims around empyema cavities.
  • Gallium scintigraphy indicated increased uptake in all cases.
  • Ultrasound aided biopsy guidance.

Conclusions:

  • Radiologists must be vigilant for malignancy in patients with chronic empyema.
  • Characteristic radiologic findings warrant further investigation.
  • Prompt cross-sectional imaging and aggressive biopsy are recommended when malignancy is suspected.