Imaging description

Benign fibrous tumors of the pleura are rare tumors of mesenchymal origin that are typically solitary and slow growing [1–3]. They may widely range in size and most often occur in the inferior hemithorax [1–3]. On radiographs as well as CT, the tumor may change location with time, patient position or respiration as 40% have a vascular pedicle that attaches it to the pleural surface and allows mobility within the pleural space [1–4]. On CT, smaller tumors are usually of homogeneous attenuation similar to muscle, with smooth, tapering margins and obtuse angles with the pleura (Figures 68.1 and 68.2) [1, 2, 5]. Larger tumors may be heterogeneous, are more often lobulated, and may form an acute angle to the pleural surface [1, 2, 5] (Figure 68.2). CT enhancement may occur and is often homogeneous in smaller tumors but may be heterogeneous in tumors with necrosis, myxoid degeneration, or hemorrhage [5]. Calcification occurs in less than 10% of cases. When present, it is usually punctate and occurs in the larger tumors [2]. Associated pleural effusions may occur [1, 2].