A 60-year-old patient with a history of asbestos exposure has a CT showing a pleural-based mass with a 'comet-tail' sign (curved vessels and bronchi converging toward the mass) and adjacent pleural thickening. Which of the following is the most likely diagnosis?
- A Malignant mesothelioma
- B Solitary fibrous tumor of the pleura
- C Rounded atelectasis ✓
- D Pleural metastasis
Correct answer: C. Rounded atelectasis
Explanation
Rounded atelectasis is a benign condition associated with asbestos exposure, characterized by a pleural-based mass with a comet-tail sign (curved bronchi and vessels converging into the mass) and adjacent pleural thickening. It is a pseudotumor that can mimic lung cancer. Malignant mesothelioma shows diffuse nodular pleural thickening. Solitary fibrous tumor is a well-circumscribed pleural mass without the comet-tail sign. Pleural metastases show nodular deposits with effusion.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.