Mesothelioma

Question 1

Define mesothelioma

Answer 1

Aggressive tumour of the mesothelial cells, which can occur in the pleura (90%) but can also occur at other sites, such as the peritoneum, pericardium & testes

Question 2

Aetiology of mesothelioma

Answer 2

Strongly related to ASBESTOS exposure

Question 3

Epidemiology of mesothelioma

prevalence, age, association x2

Answer 3

RARE
More common in elderly (> 75 yrs)
Asbestos exposure documented in 70-80% of cases
Latent period between asbestos exposure & mesothelioma may be up to 50 yrs

Question 4

Presenting symptoms & signs of mesothelioma

9

Answer 4

MOST COMMON symptoms
SOB
Chest pain (dull, diffuse & progressive)
Weight loss

Occasionally palpable chest wall mass
Fatigue
Fever
Night sweats
Clubbing (due to underlying asbestosis - pulmonary fibrosis)
Signs of metastases

Question 5

Investigations for mesothelioma

4

Answer 5

CXR/CT
MRI & PET
Pleural fluid
Pleural biopsy

Question 6

Investigations for mesothelioma - CXR/CT

2

Answer 6

shows pleural effusion

may show pleural mass & rib destruction

Question 7

Investigations for mesothelioma - pleural fluid

Answer 7

can be sent for cytological analysis & may be blood stained