Pleural Mesothelioma - Mesothelioma Links - 1/1/2003 - Health Asbestos Asbestosis Mesothelioma Lung Cancer

Pleural Mesothelioma

• a mesothelioma is associated with exposure to asbestos, especially blue asbestos. A mesothelioma is a tumour of mesothelial cells which generally occurs in the pleura (rarely a mesothelioma may occur in the peritoneum or other organs)
  
   
• exposure may only be brief. There may be a lag-time of 20 to 40 years. Only approximately 20% of patients have pulmonary asbestosis - however about 90% of patients report previous exposure to asbestosis
  
   
• Investigations:
  • chest radiography/CT shows a pleural thickening and an associated pleural effusion. These abnormalities are usually unilateral
  • pleural biopsy is required for a certain diagnosis
  • staging
    • stageI: disease confined inside the capsule of the parietal pleura: ipsilateral pleura, lung, pericardium, and diaphragm
    • stage II: as described for stage I with intrathoracic (N1 or N2) lymph nodes
    • stage III: this signifies local extension of disease into the following: chest wall or mediastinum; heart or through the diaphragm, peritoneum; with or without extrathoracic or contralateral (N3) lymph node involvement
    • stage IV: this signifies distant metastases have occurred
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• this tumour is generally only appropriate for symptomatic treatment. Curative surgical treatment may be possible with stage 1 disease.
  • extrapleural pneumonectomy - this may lengthen time to recurrence
  • palliative pain relief and relief from pleural effusions may be mediated by pleurectomy and decortication
  • no evidence that radiotherapy or chemotherapy improves survival. Radiotherapy may help with pain management
    
     
• prognosis - depends on factors such as staging, histology, patient age. If extensive disease then median survival is approximately 5 months - local disease then approximately 16 months

Reference:

1. Lancet (1995), 345,1233-4.

Links:

• clinical features
• asbestosis
• radiograph of a pleural mesothelioma