Imaging Spectrum of Mesenchymal Tumors of Lungs and Pleura.

This review covers World Health Organization classification and in-depth imaging of diverse adult and paediatric mesenchymal tumors of the thorax (lungs and pleura), highlighting their key imaging features predominantly on computed tomography (CT) including CT angiography (for intimal sarcoma), and also on other imaging modalities such as ultrasound, magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography CT (FDG PET-CT) wherever necessary. Although rare, it is essential to identify and differentiate these mesenchymal tumors from the common epithelial tumors of lungs on imaging, as their management is entirely different. Mesenchymal tumor should be suspected over epithelial tumor when the CT scan shows a large-sized, well-marginated tumor or a tumor containing fat and calcifications in adults, or a solid-cystic tumor in a relatively younger population. An algorithmic approach to diagnosing these tumors has been presented at the end based on age (children/adult), location (perihilar /intrapulmonary/ peripheral), nature of tumor (solid/solid-cystic), and content (calcification/fat), for the ease of evaluation by the radiologists.