Respiratory System >
Mesothelioma
“A malignant growth of the mesothelial cells of the pleura, or more rarely the peritoneum or pericardium“
Risk Factors
- Asbestos
Aetiology
- Asbestos Exposure
Pathophysiology
- Exposure to Asbestos
- Long latent period of 20-40 years
- Local mass + pleural effusion
Clinical Presentation
- Dyspnoea, weight loss, recurrent pleural effusions (which present with breathlessness), finger clubbing
- Signs of metastasis / invasion of local structures à chest pain, lymphadenopathy, bone pain, abdominal obstruction, hepatomegaly
Investigations
- Bloods:
- Cytology – often negative
- Imaging:
- Chest X-Ray – Pleural nodularity / effusion / plaques
- Chest CT – Pleural nodularity / thickening of >1cm
- Special:
- Pleural Aspiration – blood stained plural fluid
- Thoracoscopy – often used for cytology negative exudate effusions. Histological examination
Management
- Management often has a poor prognosis
- Conservative: n/a
- Medical:
- Chemotherapy – Pemetrexed + Cisplatin
- Surgical: n/a
Complications
- Depression
- Recurrent Pleural Effusions