Malignancies involving the mesothelial cells of the human body, including the pleura, the peritoneum, the pericardium, and the testes, are known as malignant mesothelioma, either local or diffuse. Most, but not all, cases of malignant mesothelioma in pleural (lung cancer) are usually associated with exposure to asbestos. Patients with malignant pleural mesothelioma, 77% have been exposed to asbestos in their past. The diagnosis of mesothelioma is difficult to enforce because the results of effusion fluid analysis from cancer are usually undiagnostic. Mesothelioma is more common in males than females and it occurs most commonly in the fifth decade until the 7th decade. Most cases (about 90%) of malignant mesothelioma occur in the pleura.
From the histology there are 3 types of mesothelioma mesothelioma sarcomatous, epithelial, and mixed (mixed). Pleural mesothelioma usually begins as plaque and nodules that combine to produce sheetlike neoplasm. Tumor growth usually begins at the bottom of the chest. Tumors can attack the diaphragm and envelop the surface of the lung and the interlobar gap.
As the disease progresses, it often extends to the lung parenchyma, chest wall and mediastinal wall. Pleural mesothelioma can spread to the esophagus, ribs, spine, brachial plexus, and superior cava vein.
Asbestos, amphibole asbestos, asbestos-crocidolite, and amosite asbestos in particular, are the major carcinogens involved in pathogenesis. Exposure to chrysotile asbestos is associated with a lower incidence of mesothelioma. Industrial areas often associated with mesothelioma due to asbestos exposure include the mining industry, shipbuilding involving the use of asbestos, the manufacture of cement asbestos, ceramics, grinding paper, auto parts, and railway repair plants.
From the histology there are 3 types of mesothelioma mesothelioma sarcomatous, epithelial, and mixed (mixed). Pleural mesothelioma usually begins as plaque and nodules that combine to produce sheetlike neoplasm. Tumor growth usually begins at the bottom of the chest. Tumors can attack the diaphragm and envelop the surface of the lung and the interlobar gap.
As the disease progresses, it often extends to the lung parenchyma, chest wall and mediastinal wall. Pleural mesothelioma can spread to the esophagus, ribs, spine, brachial plexus, and superior cava vein.
Asbestos, amphibole asbestos, asbestos-crocidolite, and amosite asbestos in particular, are the major carcinogens involved in pathogenesis. Exposure to chrysotile asbestos is associated with a lower incidence of mesothelioma. Industrial areas often associated with mesothelioma due to asbestos exposure include the mining industry, shipbuilding involving the use of asbestos, the manufacture of cement asbestos, ceramics, grinding paper, auto parts, and railway repair plants.
Clinical manifestations / clinical symptoms that occur in mesothelioma are:
- Dyspnea and nonpleuritic chest wall pain are the most common symptoms of malignant mesothelioma. (Approximately 60-90% of patients experience symptoms of chest pain or dyspnea.)
- In patients with malignant mesothelioma, physical findings of pleural effusion are usually known by percussion and auscultation.
- In rare cases, malignant mesothelioma manifests as cord compression, brachial plexopathy, Horner syndrome, or superior vena cava syndrome. Death is usually caused by infection or respiratory failure from the development of mesothelioma.
- The main areas that often occur in the pleura (87%), peritoneum (5.1%), and pericardium (0.4%).
EmoticonEmoticon