Mesothelioma

Question 1

Define Mesothelioma?

Answer 1

Aggresive tumour of the mesothelial cells, which usually occurs in the plerua (90%) but can also occur in other sites, such as the peritoneum, pericardium and testes

Question 2

What is the aetiology of Mesothelioma?

Answer 2

Strongly related to ASBESTOS exposure

Question 3

What is the epidemiology of Mesothelioma?

Answer 3

RARE
More common in ELDERLY (> 75 yrs)
Asbestos exposure is documented in 70-80% of cases
Latent period between asbestos exposure and Mesothelioma may be up to 50 yrs

Question 4

What are the most common symptoms of Mesothelioma?

Answer 4

SOB
Chest pain (dull, diffuse and progressive)
Weight loss

Question 5

What are the other symptoms of Mesothelioma?

Answer 5

Occasionally palpable chest wall mass
Fatigue
Fever
Night Sweats
Clubbing (due to underlying asbestosis (pulmonary fibrosis))
Signs of metastases (e.g. hepatomegaly, bone pain and tenderness)

Question 6

What investigations do we do for Mesothelioma?

Answer 6

CXR/CT
MRI and PET
Pleural fluid
Pleural biopsy

Question 7

What do we see on a CXR/CT for Mesothelioma?

Answer 7

Shows pleural effusion

May show a pleural mass and rib destruction

Question 8

What can we do with Pleural Fluid for Mesothelioma?

Answer 8

Can be sent for cytological analysis and may be blood-stained