Pleural,Mesotheloma-,Facts,you health Pleural Mesotheloma- Facts you should know
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There are two main types;1]the localized mesothelioma{benign and malignant types}2]the diffuse malignant mesotheliomaCausesThere is a strong correlation between asbestos exposure and thedevelopment of mesothelioma,although a history of exposure is notalways obtainable in patients who have mesothelioma.There are 2 typesof asbestos fibres based on crystallinestructure;a-serpentine{chrysolite}and b-amphibole.Included within the amphibole are amosite,tremolte,crocidolite andanthophyllite.The most harmful is the crocidolite or better known asblue asbestos.Localised Benign MesotheliomaThese characteristically arise from the inner layer of the pleuraSymptoms and signs;-chest pain-shortness of breath -most of the times there are no symptoms{asymptomatic},these tumors are usually discovered on routine chest x-ray -hypoglycaemia {low blood sugar}is sometimes associated TreatmentSurgery is the main stay of treatment,the tumor is removed by thesurgeon and reccurence is rare and when it happens transition tomalignant form of tumor should be suspected.Localised Malignant MesotheliomaSymptoms and Signs;-chest pain-cough-fever -shortness of breathTreatmentSurgery is also the treatment of choice,although prognosis is very poorDiffuse Malignant MesotheliomaThis type of mesothelioma can arise form any part of the pleura andoften extend into the peritoneum as well as into the ribs and chestwall{peritoneal mesothelioma and pericardial mesothelioma}.It alsospreads commonly to the liver, brain and adrenal glands.Histologicallymalignant mesothelioma have both fibrous{sarcomatous mesothelioma}andepithelial{papillary}components.Investigations-CT scan of the chest is extremely useful in diagnosing the extent ofthe tumor.-Needle biopsy{the surgeon inserts a special needle into the pleura totake samples of the tumor which is taken to the laboratory to see underthe microscope}of the pleura is a must.-Pleural fluid is aspirated and taken to the lab for microsopicexamination.Staging of Malignant Pleural Mesothelioma-Stage 1:Involvement of ipsilateral pleura and lungs{affecting just onelung either left or right lung}-Stage 2-Involvement of chest wall,mediastinum{structure at the middleof the heart},pericardium or contralateral{opposite side}pleura-Stage 3-Distant blood spread into other organs eg brain,adrenalsTreatmentTreatment is discouragingly ineffective and survival rarely longer than2 years with an average of 10-14 months.In selected cases with stage 1a radical surgery-pleuropneumonectomy{removal of lung and pleura} may beeffective,but long term survival is rare.Primary radiation therapy maybe used also.Combination chemotherapy using either single agent or combinationprotocols have also been used but the outcome remains dismal. Article Tags: Malignant Mesothelioma
Pleural,Mesotheloma-,Facts,you