CT Scans Used to Distinguish Malignant Peritoneal Mesothelioma from Tuberculous Peritonitis

CT Scans Used to Distinguish Malignant Peritoneal Mesothelioma from Tuberculous Peritonitis

A new report from researchers in China suggests that CT scanning may be useful for identifying peritoneal mesothelioma. The study, titled CT differentiation of malignant peritoneal mesothelioma and tuberculous peritonitis,” appeared on Dec. 11, 2015, in the journal La Radiologia Medica.

Mesothelioma refers to a tumor in the lining of the lung, stomach, heart, or other organs that usually results from the inhalation or swallowing of airborne asbestos. According to the National Institutes of Health, approximately 11 million people were exposed to asbestos in the U.S. between 1940 and 1978, putting them at risk for mesothelioma. Malignant peritoneal mesothelioma is an uncommon form of this cancer, occurring in less than 500 people in the U.S. each year. It is found in the thin cell walls surrounding the abdominal cavity, called the peritoneum, that lubricate the abdominal cavity and allow organs to contract and expand.

Peritoneal mesothelioma (MPM) can be confused with a condition known as tuberculous peritonitis (TBP), caused by tuberculosis infection affecting the peritoneum.

The current study, led by Wen-jie Yin of  the Department of Gastroenterology, Cangzhou Central Hospital, Hebei, China, sought to evaluate whether computed tomography (CT) can be used to distinguish peritoneal mesothelioma (MPM) from tuberculous peritonitis (TBP).

The researchers performed CT scans in 53 people with MPM and compared them to CT scans from 27 people with TBP. The scientists used standard CT measurements and analyzed them statistically to find differences between the groups.

Several similarities and differences were found between the two groups of CT scans. Both groups had high thickening of the peritoneum and mesenterium (a specific part of the peritoneum). In addition, there were no differences in peritoneal fluid accumulation or swollen lymph nodes. However, according to the report, the two groups had differences in smooth peritoneal thickening, which occurred more often in patients with TBP. Irregular peritoneal thickening was more common in patients with MPM. Several additional CT measurements also had statistically measurable distinctions.

In their report, the authors concluded, “Although most CT findings analyzed are observed in both diseases, each disease has its own several unique characteristics. Therefore, using a combination of CT findings may increase our ability to distinguish TBP from MPM.”

Based on this study, CT scanning may be a way to distinguish between these two conditions, leading to improvements in the selection of specific and appropriate therapies and, possibly, the initiation of earlier treatment.

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