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K. Inai
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-024 - CT Findings of Early Pleural Mesothelioma and Benign Asbestos Pleural Effusion (ID 272)
09:30 - 09:30 | Author(s): K. Inai
- Abstract
Background:
• Malignant pleural mesothelioma is known as disease of the poor prognoses. • Our purpose is to find useful CT findings for correct differentiation between Malignant Pleural Mesothelioma in the early stage (e-MPM) and Benign Asbestos Pleural Effusion (BAPE) to improve prognosis of MPM.
Methods:
• The BAPE group consisted of 36 patients diagnosed at Okayama Rosai Hospital since Jan 2000. In all BAPE patients thoracoscopic biopsies were conducted to exclude malignant diseases including MPM. • In e-MPM group, 66 patients who were diagnosed mesotheliomas with T1 or T2 (IMIG system) by the CT evaluation were studied. The e-MPM patients were selected from 2,742 mesothelioma death cases of Japanese vital statistics of 2003-05. • We evaluated CT scans taken at the time of diagnosis for each group. The evaluating items were presence of asbestosis, pleural plaque (PQ), rounded atelectasis (RA) and diffuse pleural thickening (DPT), as well as the grade and localization of pleural irregularities.
Results:
• In BAPE group (36 cases), the occurrence rate of asbestos-related lesions was significantly higher than in e-MPM group (66 cases) as follows; prevalence of asbestosis 17%/2% (*), PQ 92%/35% (**), RA 44%/0% (**) and DPT 25%/2% (**). (*P=0.0038 **P<0.001) • As for grade of pleural irregularity, no irregularity was found in 22%/9%, low-level irregularity in 72%/54%, high-level irregularity in 5%/23% and mass formation in 0%/14% of BAPE and e-MPM group patients, respectively. • As for localization (including overlap) of pleural irregularity, irregularity in mediastinal pleura was observed in 30%/74%, basal pleura in 91%/77% and interlobar pleura in 0%/55% of BAPE and e-MPM group patients, respectively. The mediastinal pleural thickening was minimal in BAPE group and found regressed in the follow-up CT scans.
Conclusion:
• In BAPE group the occurrence rate of asbestos-related lesions was higher than in e-MPM group. • Because the 5% of BAPE cases presented irregular pleural thickening, the differentiation with MPM was difficult in such case. • The mediastinal pleural thickening, which is considered to be a characteristic of MPM, was also observed in 30% of BAPE cases. However, the finding disappeared during observation. And no BAPE case with interlobar pleural irregularity was found. These findings can be useful for differentiation BAPE and e-MPM cases.
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P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.08-005 - Mesothelioma Diagnostic Panel Using Remote Digital Diagnostic System in Japan (ID 480)
09:30 - 09:30 | Author(s): K. Inai
- Abstract
Background:
The pathological diagnosis as mesothelioma is difficult even if experienced pathologists do. Also the diagnosis of imaging including CT has no conclusive evidences as mesothelioma. Accordingly comprehensive diagnosis based on discussion by several pathologists and/or radiologists is necessary. However most of diagnostic specialists are too busy to have a meeting at designated date and venue. New remote diaignostic system will solve those problems and the accurate diagnosis as mesothelioma can be made.
Methods:
The remote pathological diagnosis consists of scanning of tissue slide by scanning equipment (NanoZoomer®), transmission of the digital data to cloud system (Google) by Internet. We have developed a new system named “LOOKREC” including pathological data and imaging data (chest X-P,CT and so on). The pathologists and radiologists as a member of special diagnostic group obtain a special account and access to the data on cloud by Internet. The diagnotic opinions made by individuals are entered into the discussion sheet and the organizer will decide a final diagnosis including whether mesothelioma or not, which type of mesothelioma, based on individual diagnostic opinions.
Results:
In Japan, the annual number of occurrence of mesothelioma is over 1200. The compensation or relief system for mesothelioma patients has been established ten years ago, and the accurate diagnosis is always required for adequate management of those systems. The number of mesothelioma showing diagnostic problems is about 10% of all mesothelioma cases. The cases with some difficulties of differentiation between early epithelioid mesothelioma vs reactive mesothelial hyperplasia, pleuritis, localized methelioma vs lung cancer will be presented and the points of differential diagnosis will be discussed.
Conclusion:
The new remote diagnostic system using Internet has been developed. It is expected that diagnostic accuracy will be improved when the observation of pathological findings as well as imaging and effective disccussion on the web will be done by pathologists and radiologists.
