Pericardial involvement of malignant pleural mesothelioma: Comparison of two imaging methods

Malignant pleural mesothelioma (MPM) tends to progress locally. Data relating pericardial involvement is limited. In this study, the relationship between pericardial involvement and the severity of the disease was investigated. Total of 27 MPM patients; 9 (33%) female, 18 (67%) male who were followed-up between January 2001-December 2003 in Chest Diseases and Thoracal Surgery departments of Dicle University Hospital were included to the study. The mean age was found as 51.8+- 12.3 (22-82). Of patients 23 (85%) had asbestos exposure and it was environmental. Of patients, 22 ( 82%) was diagnosed by pleural biopsy, 5 (18%) by operative methods. Epithelial type was detected in 11 cases, mixed type in 3 cases and sarcomatous type in 1 case. Type detection could not be done in 12 patients. Stage 1 included 18 (67%) patients, stage 2 included 8 (29%) patients and stage 3 included 1 (4%) patient. Pericardial involvement was investigated by echocardiographic method. Totally 19 (70%) patients were found to have pericardial involvement. Of these cases; 9 patients had pericardial thickening, 8 had increasement of pericardial echogenity, 2 had pericardial mass and 2 had pericardial effusion. No relationship was detected between the stage of the disease and echocardiographic pericardial involvement. Torax CT of 4 patients showed pericardial involvement. Pericardial involvement in MPM patients occurs frequently. This involvement can be detected by echocardiography easily. In these cases, routine echocardiographic investigation is a non-invasive, cheap and usefull method.