Malignant Mesothelioma

Question 1

Where does the cancer arise from?

Answer 1

Mesothelium in the pleura - the epithelial layer of the serosa - causes thickened pleura

Question 2

What substance accounts for most cases of this?

Answer 2

Asbestos - 30-50 yr latency between exposure and disease meaning exposure later in life is not problematic

Question 3

S+S:

Respiratory - 3

Systemic - think cancer - 3

Hands - 1

Cardiac - 1

Answer 3

SOB
Dull chest pain
Pleural effusion

Weight loss
Fever
Fatigue

Clubbing

Pericardial effusion

Question 4

Investigations:

CXR and chest CT:

• Why do you see pleural effusion?
• Why do you see pleural thickening?
• What disease as a precursor to this may cause interstitial changes?

A high resolution CT can be used to diagnose as well.

Answer 4

Excess fluids to accumulate, the result is a pleural effusion. The extra fluid around the lungs takes up space and fills the pleural cavity.

To prolonged exposure to asbestos. When a person inhales asbestos dust, the microscopic mineral fibres can become embedded in the pleura. This triggers an inflammatory response that causes a chronic accumulation of fluid in the pleural space.

Asbestosis

Question 5

Management:

Why may making a diagnosis be important to patients?

Answer 5

They may be looking for compensation