Dynamic contrast enhancement of asbestos-related pulmonary pseudotumours

Abstract

Several authors have described the condition of round atelectasis or pulmonary pseudotumour (Schneider et al, 1980; Cho et al, 1981; Tylen & Nilsson, 1982; Doyle & Lawler, 1984). Features have been identified on chest radiographs and computed tomography (CT) enabling differentiation of these lesions from bronchial carcinoma (Cho et al, 1981; Doyle & Lawler, 1984). The effect of intravenous contrast enhancement on the CT appearances of these lesions has not been previously recorded. Three cases of asbestos-related pulmonary pseudotumour are described which showed significant contrast enhancement. The importance of this observation is that contrast enhancement does not provide an additional criterion for separation of pseudotumour from bronchial carcinoma.

Identification of rounded atelectasis in workers exposed to asbestos by contrast helical computed tomography

“…Bronchogenic carcinoma usually concentrates contrast dye in both a homogenous and heterogenous manner (19). Therefore, the determination alone of how the contrast dye is concentrated within the lesion is insufficient for a perfect differentiation between RA and lung cancer (19).…”

“…Therefore, the determination alone of how the contrast dye is concentrated within the lesion is insufficient for a perfect differentiation between RA and lung cancer (19).…”

“…After this period, to asbestos. RA represents an area of lung collapse and might therefore show a significant increase in radiologic density after intravenous injection of contrast dye due to the vascularization of pulmonary tissue, despite the existence of adjacent fibrotic pleural areas (19). A CT study (20) demonstrating several investigators have established with excellent precision the tomographic criteria compatible with RA (12,22), in such a way that invasive procedures for the diagnosis of RA can be eliminated (12) if the alterations characteristic of RA observed upon tomography remain unchanged for a period longer than one year.…”

Contrast enhancement of round atelectases

“…administration of contrast medium, RA is seen to have several converging blood vessels with homogeneous enhancement of the folded lung. However, according to the literature, contrast enhancement does not provide any more information than non‐contrast‐enhanced CT findings in differentiating RA from bronchogenic carcinoma, since both lesions demonstrate contrast enhancement (17). In our study the measurements were performed from collected primary data on a work station, which is a more accurate method than approximate evaluation from the films.…”

“…A number of imaging features associated with RA on conventional radiography, CT, MR imaging and US have been described in the literature (1, 5, 7, 10–12, 15, 17, 19, 20). According to the present literature, contrast enhancement does not provide any more information than non‐contrast‐enhanced CT in differentiating RA from bronchogenic carcinoma since both lesions demonstrate contrast enhancement (17).…”