MESOTHELIOMA

A mesothelioma is a primary malignant neoplasm of pleura.
Etiology
  • It occurs in patients with prior exposure to asbestos.
  • It has no correlation with cigarette smoking.
Pathology
  • The neoplasm grows to encase the lung and chest wall and spreads locally.
  • Microscopically, the neoplastic cells may resemble mesenchymal stroma (sarcoma) or appear like epithelial cells.
Clinical Features
  • Patients present with SOB, cough, weight loss and chest pain.
  • Pleural effusion is a common mode of presentation.
  • Chest CT reveals pleural effusion and characteristic encasing of lung with tumor mass.
    • CXR
    • CT
  • Diagnosis is difficult with pleural fluid cytology and pleural biopsy.
  • Special stains and an experienced Pathologist are often required for diagnosis.
  • The tumor tends to grow along needle tracks. This is one reason to avoid repeated thoracentesis.
Therapy

  • No therapy has a proven benefit in prolonging life.
  • Patients usually expire within 1-2 years.
  • Extrapleural pneumonectomy is recommended by some centers.

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