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
  1. Exposure to Asbestos
  2. Long latent period of 20-40 years
  3. 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

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