Chest imaging: mesothelioma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest imaging: mesothelioma

Sample item

CT of a patient exposed to asbestos shows nodular circumferential pleural thickening that encases the lung and includes the mediastinal pleura, with a small effusion and volume loss of the hemithorax. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Malignant mesothelioma

Nodular pleural thickening exceeding 1 cm, involving the mediastinal pleura and circumferential, with a frozen hemithorax is highly suggestive of mesothelioma. Plaques spare the mediastinal pleura and costophrenic angles. Biopsy confirms the diagnosis.

Option by option

  • A. Tuberculous empyema

    Tuberculous empyema shows a split pleura sign but is less nodular.

  • B. Malignant mesothelioma (correct)

    Correct. Circumferential nodular thickening with mediastinal involvement indicates mesothelioma.

  • C. Simple pleural plaque

    Plaques are discrete and do not encase the lung.

  • D. Loculated transudate

    A transudate does not produce nodular pleural thickening.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Malignant mesothelioma. Nodular pleural thickening exceeding 1 cm, involving the mediastinal pleura and circumferential, with a frozen hemithorax is highly suggestive of mesothelioma.

Why is "Tuberculous empyema" not the answer?

Tuberculous empyema shows a split pleura sign but is less nodular.

Why is "Simple pleural plaque" not the answer?

Plaques are discrete and do not encase the lung.

Why is "Loculated transudate" not the answer?

A transudate does not produce nodular pleural thickening.

What concept does this question test?

It tests Chest imaging: mesothelioma in Radiology. Plaques spare the mediastinal pleura and costophrenic angles. Biopsy confirms the diagnosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: mesothelioma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.