Mesothelioma FRCR CO2A Flashcards
What is mesothelioma?
Mesothelioma is a challenging disease linked to asbestos exposure, with a long latent period between exposure and disease development.
What percentage of mesotheliomas affect the pleura?
94.5% of mesotheliomas affect the pleura.
What are the types of pleural tumours?
The most common pleural tumours are metastatic from other sites.
What are the two parts of the pleura?
The pleura consists of the parietal pleura and the visceral pleura.
What is the function of pleural fluid?
Pleural fluid reduces friction during respiration.
What regions is the parietal pleura divided into?
The parietal pleura is divided into cervical, costal, diaphragmatic, and mediastinal regions.
What is the incidence of mesothelioma for males?
The incidence of mesothelioma is 5.2 in 100,000 per year for males.
What is the male-to-female ratio for mesothelioma?
The male-to-female ratio for mesothelioma is 5.5:1.
What is the primary aetiological factor in mesothelioma?
Exposure to asbestos is the single most important aetiological factor in mesothelioma.
What is the mean latent interval between asbestos exposure and death?
The mean latent interval is 41 years.
What are the two types of asbestos?
The two types of asbestos are amphibole and chrysotile.
What are common products that contain asbestos?
Common asbestos-containing products include roofing materials, fire protection materials, electrical casings, and water pipe products.
What are some clinical effects of asbestos exposure?
Clinical effects include asbestosis, pleural plaques, diffuse pleural fibrosis, pleural effusion, mesothelioma, and lung cancer.
What are the pathological features of malignant mesothelioma?
Pathological features include diffuse and localized forms, with microscopic types being epithelioid, sarcomatoid, desmoplastic, and biphasic.
What is a possible mechanism of carcinogenesis in mesothelioma?
Asbestos fibres induce DNA and chromosome damage, and SV 40 may act as a co-factor.
What are other possible aetiological factors for mesothelioma?
Other factors include erionite rock, sugar cane, ionising radiation, pleural scars, and SV 40 contamination.
What are the main pathological types of mesothelioma?
Epithelioid, sarcomatoid, and biphasic
The term desmoplastic refers to sarcomatoid mesothelioma with dense collagen stroma.
What are common clinical features of pleural mesothelioma?
- Incidental finding of pleural effusion or pleural thickening
- Weight loss
- Finger clubbing
- Profuse sweating
Other less common features include chest wall mass, abdominal pain, and hoarseness of voice.
What imaging techniques are used in the investigation of mesothelioma?
- Chest X-ray
- Ultrasound
- CT scan
- MRI scan
These techniques can reveal pleural thickening, masses, and invasion of surrounding structures.
What pathological confirmation methods are used for diagnosing mesothelioma?
- Cytological examination of pleural fluid
- Immunocytochemistry
- Ultrasound-guided percutaneous biopsy
- Thoracoscopic or open biopsy
Blind biopsy techniques like Abrams’ punch biopsy are less effective for diagnosis.
What does the TNM staging classification refer to?
A system used to classify the extent of cancer spread
This classification is essential for determining treatment and prognosis.
What are the local routes of spread for mesothelioma?
- Chest wall
- Intercostal nerves
- Ribs
- Mediastinum
- Vertebral body
- Diaphragm and liver
Local spread often involves adjacent structures.
What are the sites of metastatic spread in mesothelioma?
- Bone
- Contralateral lung
- Liver
- Brain
Distant metastases occur commonly but are often asymptomatic.
