scholarly journals Pathological Approach to Pleural Malignant Mesothelioma

Author(s):  
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Exposure to asbestos can lead to asbestosis or malignancy 10-40 years after initial exposure [1]. Although its use has been banned in multiple countries, past occupational exposure leads to most cases that we see in present time. Malignant mesothelioma is an insidious and rare neoplasm that can arise from mesothelial surface cells, being Malignant Pleural Mesothelioma (MPM) the most common type. Lifetime risk of developing mesothelioma among asbestos workers can be as high as 10 percent and latency period is approximately 30-40 years since time of exposure to development of disease [2]. Annual incidence in the united states is approximately 3,300 cases per year [3]. Median overall survival of patients with advanced unresectable disease is approximately 12 months [4]. Clinical suspicion should arise in patients with previous exposure to asbestos who present with pleural thickening and/or effusion with associated respiratory symptoms. Most symptoms are nonspecific such as chest pain, dyspnea, cough and night sweats. Initial evaluation includes chest x-ray, contrast enhanced CT of the chest to find pleural abnormalities, thoracentesis and closed pleural biopsy. However, difficulties establishing diagnosis have been illustrated on studies where thoracentesis and pleural fluid cytology only yields diagnosis in 26% of cases. The diagnosis, then, is established by morphologic and immunohistochemistry findings of cytologic and surgical specimens.

2004 ◽  
Vol 11 (4) ◽  
pp. 287-290 ◽  
Author(s):  
Inci Gulmez ◽  
Levent Kart ◽  
Hakan Buyukoglan ◽  
Ozlem Er ◽  
Suleyman Balkanli ◽  
...  

BACKROUND:Malignant mesothelioma (MM) is a fatal neoplasm which frequently results from exposure to asbestos or erionite.METHOD:Sixty-seven patients with MM were seen between 1990 and 2001. Their clinical and radiological features, as well as the therapy, were retrospectively evaluated.RESULTS:In 51 patients (76.1%), the MM was confined to the pleura, in 14 patients it was exclusively peritoneal and in two patients, it involved both areas. Of the 67 cases, 35 (52.2%) were women. The mean (± SD) age for all cases was 57.6±11.5 years. Dyspnea (67.2%), cough (55.2%) and chest pain (50.7%) were the most frequent symptoms of onset. Pleural effusion (92.4%) was the most common chest x-ray finding, whereas pleural effusion (60.8%), pleural nodules (34.7%) and pleural thickening (34.7%) were the most common computed tomography findings in pleural MM patients. The histological subtypes of MM were determined as epithelial in 60 patients (89.5%), sarcomatous in four patients (5.9%) and mixed in three patients (4.4%). Although 50.7% and 25.4% of the cases were exposed to erionite and asbestos, respectively, 23.9% of the cases recalled no exposure to asbestos or erionite. Exposures were environmental as opposed to occupational. Thirty-five patients (52.2%) were administered chemotherapy, and follow-up data were available for 22 patients. For these patients, the two-year survival rate was 22% and the two-year progression-free interval was 15.7%. There were no differences between patients with asbestos and erionite exposure.CONCLUSION:MM should be considered when exudative pleural effusion is detected in a patient who has been exposed to asbestos or erionite. MM is a major public health problem in parts of Turkey and compulsory environmental control of fibrous mineral should be considered.


2021 ◽  
Vol 73 (9) ◽  
pp. 594-602
Author(s):  
Krittachat Butnian ◽  
Nisa Muangman ◽  
Kanyarat Totanarungroj ◽  
Suwimon Wonglaksanapimon

Objective: To compare CT findings between malignant pleural mesothelioma (MPM) and metastatic pleuraldisease (MPD).Materials and Methods: CT chest images of 157 cases of pathologically-proven malignant pleural disease(21 MPM, 136 MPD) were retrospectively reviewed by two radiologists who were blinded to the diagnosis. Findingsof interest included pleural effusion, pleural thickening, organ invasion, lymphadenopathy, dominant lung nodule,pulmonary or extra-thoracic organ metastasis, and asbestos-related disease.Results: Findings commonly found in MPM compared with MPD are circumferential pleural thickening (52.4%vs 14.0%, p<0.001), pleural mass (33.3% vs 7.4%, p<0.001), organs invasion (57.1% vs 9.6%, p<0.001), and asbestosrelated disease (19% vs 0%, p<0.001).Conclusions: Circumferential pleural thickening, pleural mass, presence of organ invasion, and CT finding ofasbestos-related pleural disease were the CT findings that raise the possibility of MPM.


2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
C Schimmer ◽  
M Weininger ◽  
K Hamouda ◽  
C Ritter ◽  
SP Sommer ◽  
...  

2014 ◽  
pp. 159-167
Author(s):  
Huu Thuan Ngo ◽  
Minh Loi Hoang ◽  
Van Dinh Nguyen ◽  
Dinh Duyen Nguyen

Objectives: Imaging characteristis of MDCT in nasopharyngeal carcinoma. Subject and methods: Cross- sectional study in 51patients with nasopharyngeal carcinoma by MDCT at Danang Cancer Hospital from January 2013 to July 2014. Results: The findings reveal that the tumor in lateral wall (66.7%), diameter > 2cm (64.7%), hypodensity (98%), contrast- enhanced CT (62.7%). Blunting of fossa of Rosenmuller (96.1%), invasion of parapharyngeal space (62.7%), destruction of pterygoid bone (19.6%), invasion of skull base (17.6%), destruction of sphenoid bone (9.8%). Lymph nodes metastasis (96.1%), diameter (> 1- 3cm) is 58.8%. T-staging by CT showed T1 (35.3%), T2 (37.3%), T3 (17.6%) and T4 (9.8%). N- staging by CT showed N2 (66.7%), N3a- N3b (19.6%). Staging of Nasopharyngeal carcinoma: stage II-III (60.8%), stage IVA-IVB (23.5%) and stage IVC (11.8%). Conclusions: MDCT with a thinner slice thickness and high quality images is able to detect lymph nodes metastasis with small size and those in deep neck area and assess comprehensively the invasion of the tumor. Key words: Nasopharyngeal carcinoma, MDCT


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