Is thoracic CT adequate for diagnosis and differential diagnosis in patients with pleural thickening?

Objective: Lung pathologies associated with pleural thickening are presented along with similar clinical and radiologicalfindings. The present study highlights the importance of the differential diagnosis verification of patients with pleuralthickening. Video-assisted thoracoscophic surgery (VATS) is one of the most common diagnostic and therapeutic methodused for this purpose. In this study, we aim to deliver our clinical investigation results on patients diagnosed with pleuralpathology in the light of recent literature.Method: In this study, data of 40 patients that were applied single-port VATS pleural biopsy in our clinic between May2012 and June 2014 were retrospectively assessed. Thoracic CT and pathology results were compared. Clinical diagnosis,radiologic findings, and biopsy results were evaluated retrospectively.Results: The average age of the patients is 59.15 ±12.13 (age range 23, 82). There was an environmental exposure toasbestos in 14 patients (35%). Twenty-five patients (62.5%) were followed-up with the diagnosis of mesothelioma withclinical and radiological findings, 8 patients (20%) of tuberculosis, 4 patients (10%) of pleural metastasis and 3 patients(7.5 %) of pleuritis. Histopathologically 8 patients (20%) were diagnosed with malignant mesothelioma, 1 patient (2.5%) was localized fibrous tumor, 2 patients were (5%) diagnosed with reactive mesothelial hyperplasia, 6 patients (15%)were malignant epithelial tumor metastasis, 16 patients (40%) were fibrinous pleuritis, 6 patients (15%) were chronicgranulomatous inflammation, and 1 patient (2.5%) was chronic lymphocytic inflammation.Conclusions: The present study demonstrates insufficiency of thoracic CT for diagnosis and differential diagnosis due tosimilar clinical and radiological findings associated with pathological pleural thickening. Histopathologic examination isrequired for diagnosis. However, thoracic CT is still a method of radiographic imaging that is actively used indetermination of pleural biopsy position, evaluation, and clinical monitoring of response to treatment.