Skip to main content

Advertisement

SpringerLink
Log in

CT differentiation of malignant peritoneal mesothelioma and tuberculous peritonitis

  • ABDOMINAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to determine which computed tomography (CT) findings were useful in differentiating malignant peritoneal mesothelioma (MPM) and tuberculous peritonitis (TBP).

Methods

CT scans performed in 53 patients with MPM and 27 patients with TBP confirmed by pathology were retrospectively reviewed. The CT findings were evaluated for the morphologic appearance of ascites, peritoneum, mesenterium and omentum involvement, enlarged lymph nodes, solid abdominal viscera infiltration and metastases, and thoracic changes. The Pearson χ 2 test was used to compare differences between groups.

Results

Patients in both groups displayed a high proportion of peritoneum and mesenterium thickening. However, there were no obvious differences observed for ascites or swollen lymph nodes. There were significant differences in the following aspects between the two groups: (1) smooth peritoneal thickening was more frequent in patients with TBP, while irregular thickening was more frequently observed in patients with MPM; (2) caked omentum stratification was more common in patients with MPM; (3) mesentery involvement was less commonly observed in patients with TBP; (4) abdominal viscera infiltration and pleural plaques were more common in patients with MPM (46/53 and 48/53, respectively) than in those with TBP (0/27 and 0/27); and (5) more patients in the TBP group (14/27) displayed pleural effusion, and extraperitoneal tuberculosis was more common in patients with TBP (20/27).

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Picklesimer AH, Zanagnolo V, Niemann TH, Eaton LA, Copeland LJ (2005) Case report: malignant peritoneal mesothelioma in two siblings. Gynecol Oncol 99(2):512–516

    Article  PubMed  Google Scholar 

  2. Robinson BW, Lake RA (2005) Advances in malignant mesothelioma. N Engl J Med 353:1591–1603

    Article  CAS  PubMed  Google Scholar 

  3. Munkholm-Larsen S, Cao CQ, Yan TD (2009) Malignant peritoneal mesothelioma. World J Gastrointest Surg 1(1):38–48

    Article  PubMed  PubMed Central  Google Scholar 

  4. Thoeni RF, Margulis AR (1979) Gastrointestinal tuberculosis. Semin Roentgenol 14:283–294

    Article  CAS  PubMed  Google Scholar 

  5. Akpolat T (2008) Tuberculous peritonitis. In: Proceedings of the ISPD 2008: the 12th congress of the ISPD June 20–24. Istanbul, Turkey

  6. Na-ChiangMai W, Pojchamarnwiputh S, LerTB Prasertsuke N, Chitapanarux T (2008) CT findings of tuberculous peritonitis. Singap Med J 49(6):488

    CAS  Google Scholar 

  7. Yan TD, Haveric N, Carmignani CP, Bromley CM, Sugarbaker PH (2005) Computed tomographic characterization of malignant peritoneal mesothelioma. Tumori 91(5):394–400

    PubMed  Google Scholar 

  8. Mazzei MA, Khader L, Cirigliano A, Cioffi Squitieri N, Guerrini S, Forzoni B, Marrelli D, Roviello F, Mazzei FG, Volterrani L (2013) Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Abdom Imaging 38(6):1422–1430

    Article  PubMed  Google Scholar 

  9. Vázquez Muñoz E, Gómez-Cerezo J, Atienza Saura M, Vázquez Rodriguez JJ (2004) Computed tomography findings of peritoneal tuberculosis: systematic review of seven patients diagnosed in 6 years (1996–2001). Clin Imaging 28(5):340–343

    Article  PubMed  Google Scholar 

  10. Yoneshima S, Nagata N, Kumazoe H, Kajiki A, Katahira K, Okamura K, Omura H, Taguchi K, Minami T, Wakamatsu K, Kitahara Y (2011) Clinical review of 8 patients with tuberculous peritonitis. Kekkaku 86(4):431–436

    PubMed  Google Scholar 

  11. Yan TD, Haveric N, Carmignani CP, Chang D, Sugarbaker PH (2005) Abdominal computed tomography scans in the selection of patients with malignant peritoneal mesothelioma for comprehensive treatment with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Cancer 103(4):839–849

    Article  PubMed  Google Scholar 

  12. Husain AN, Colby T, Ordonez N et al (2013) Guidelines for pathologic diagnosis of malignant mesothelioma: 2012 update of the consensus statement from the international mesothelioma interest group. Arch Pathol Lab Med 137(5):647–667

    Article  PubMed  Google Scholar 

  13. Kang SJ, Kim JW, Baek JH, Kim SH, Kim BG, Lee KL, Jeong JB, Jung YJ, Kim JS, Jung HC, Song IS (2012) Role of ascites adenosine deaminase in differentiating between tuberculous peritonitis and peritoneal carcinomatosis. World J Gastroenterol 18(22):2837–2843

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Koh DM, Hughes M, Husband JE (2006) Cross-sectional imaging of nodal metastases in the abdomen and pelvis. Abdom Imaging 31(6):632–643

    Article  CAS  PubMed  Google Scholar 

  15. Baratti D, Kusamura S, Deraco M (2011) Diffuse malignant peritoneal mesothelioma: systematic review of clinical management and biological research. J Surg Oncol 103(8):822–831

    Article  PubMed  Google Scholar 

  16. Sugarbaker PH, Welch LS, Mohamed F, Glehen O (2003) A review of peritoneal mesothelioma at the Washington Cancer Institute. Surg Oncol Clin N Am 12:605–621

    Article  PubMed  Google Scholar 

  17. Ahmed I, Ahmed Tipu S, Ishtiaq S (2013) Malignant mesothelioma. Pak J Med Sci 29(6):1433–1438

    PubMed  PubMed Central  Google Scholar 

  18. Kindler HL (2013) Peritoneal mesothelioma: the site of origin matters. Am Soc Clin Oncol Educ Book. doi:10.1200/EdBook_AM.2013.33.182

    PubMed  Google Scholar 

  19. Wei SC, Zheng GQ et al (2013) Retrospective analysis of 162 patients with malignant peritoneal mesothelioma in Cangzhou residents (Chinese). Chin J Intern Med 52(07):599–601

    Google Scholar 

  20. Abdelaal A, Alfkey R, Abdelaziem S, Abunada M, Alfaky A, Ibrahim WH, Toro A, Di Carlo I (2014) Role of laparoscopic peritoneal biopsy in the diagnosis of peritoneal tuberculosis: a seven-year experience. Chirurgia (Bucur) 109(3):330–334

    CAS  Google Scholar 

  21. Yang HQ, Yao WG, Huang GL, Zhang JF (2011) CT diagnosis is of asbestos-related malignant peritoneal mesothelioma (Chinese). Diagn Imaging Interv Radiol 20(6):418–421

    Google Scholar 

  22. Chua TC, Yan TD, Morris DL (2009) Surgical biology for the clinician: peritoneal mesothelioma: current understanding and management. Can J Surg 52:59–64

    PubMed  PubMed Central  Google Scholar 

  23. Leder RA, Low VH (1995) Tuberculosis of the abdomen. Radiol Clin N Am 33:691–705

    CAS  PubMed  Google Scholar 

  24. Kebapci M, Vardareli E, Adapinar B, Acikalin M (2003) CT findings and serum ca 125 levels in malignant peritoneal mesothelioma: report of 11 new cases and review of the literature. Eur Radiol 13(12):2620–2626

    Article  PubMed  Google Scholar 

  25. Kharrat J, Gargouri D, Ouakaa A et al (2003) Laparoscopic aspects of peritoneal tuberculosis: report of 163 cases (French). Tunis Med 81:558–562

    PubMed  Google Scholar 

  26. Ha HK, Jung JI, Lee MS et al (1996) CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR 167:743–748

    Article  CAS  PubMed  Google Scholar 

  27. Souza FF, Jagganathan J, Ramayia N, Johnston C, Jackman D, Abbeele AV, Ros PR (2010) Recurrent malignant peritoneal mesothelioma: radiological manifestations. Abdom Imaging 35(3):315–321

    Article  PubMed  Google Scholar 

  28. Raptopoulos V, Gourtsoyiannis N (2001) Peritoneal carcinomatosis. Eur Radiol 11(11):2195–2206

    Article  CAS  PubMed  Google Scholar 

  29. Akhan O, Pringot J (2002) Imaging of abdominal tuberculosis. Eur Radiol 12:312–323

    Article  PubMed  Google Scholar 

  30. Wang HJ, Li MH, Shi SB et al (2010) The clinical value of spiral CT in the diagnosis of tuberculous peritonitis and cancerous peritonitis (Chinese). J Pract Med 26(15):2793–2795

    Google Scholar 

  31. Ahmed ME, Hassan MA (1994) Abdominal tuberculosis. Ann R Coll Surg Engl 76(2):75–79

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Jeong YJ, Kim S, Kwak SW, Lee NK, Lee JW, Kim KI, Choi KU, Jeon TY (2008) Neoplastic and nonneoplastic conditions of serosal membrane origin: cT findings. Radiographics 28(3):801–817

    Article  PubMed  Google Scholar 

  33. Dai YB, Zhou YP (2006) The clinical value of spiral CT in the diagnosis of peritoneum mesothelioma (Chinese). J Clin Exp Med 5(06):768–769

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Cangzhou Central Hospital, Cangzhou, 061001, Hebei, China

    Wen-jie Yin, Guo-qi Zheng, Ning-ning Sun, Yu-xin Yang & Xin-yi Sun

  2. Department of Magnetic Resonance Imaging, Cangzhou Central Hospital, Cangzhou, 061001, Hebei, China

    Yue-feng Chen, De-qiang Chen & Li-qing Kang

Authors
  1. Wen-jie Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guo-qi Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yue-feng Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. De-qiang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ning-ning Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yu-xin Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xin-yi Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Li-qing Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guo-qi Zheng.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical standards

Ethical approval was obtained from the Ethics Committee Board of the participating hospital.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yin, Wj., Zheng, Gq., Chen, Yf. et al. CT differentiation of malignant peritoneal mesothelioma and tuberculous peritonitis. Radiol med 121, 253–260 (2016). https://doi.org/10.1007/s11547-015-0609-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-015-0609-y

Keywords

Search

Navigation