DIAGNOSTIC PATHWAY FOR THORACIC MALIGNANCY
MALIGNANT PLEURAL MESOTHELIOMA
Malignant Pleural Mesothelioma (MPM) is a progressive, terminal disease of the pleural cavity. This tumour can be divided per their histology (2). Epithelioid is the most common mesothelioma while sarcomatoid type is the least common. The biphasic mesothelioma is a combination of the epithelioid and sarcomatoid type. The sarcomatoid mesothelioma is the lest common. Asbestos have been identified as the predominant cause of MPM (3). Asbestos is a natural silicate mineral that can be divided into serpentine and amphibole types (3, 4). Serpentine asbestos are short fibres that can be easily removed from the lung by macrophages towards airways or lymphatics (4,5). Moreover …show more content…
The most common symptoms are pleural effusion, following by non-pleuratic chest pain, dyspnea, fever, weight loss and fatigue (4). With time, pleural effusion accumulates and the pleura congeals to form a rind that encases the lung (4). The estimated range of survival after diagnosis of MPM are 7 to 17 months (3). However, the stage of the tumour cannot be used to predict the outcome of the disease. The most favourable outcomes have been associated to the epithelioid type, while the least favourable outcomes are linked to the sarcomatoid type (1,3). The clinical signs that can help producing a poor prognosis are age greater than 75 years, male gender, and pleural involvement (1,3).
DIAGNOSIS
Diagnosis of MPM is specially challenging due to the difficulty to distinguish it from benign pleural effusions and lung adenocarcinomas (4). Pleural biopsy, histopathologic analysis are the common methods used to diagnose MPM. Although histopathologic analysis is considered the gold standard diagnosis, it can be supported by ancillary techniques, such as molecular biology, electron microscopy and biomarker analysis (4,8). Immunohistochemistry (IHC) requires at least two positive immune-reactive and two negative immune-reactive markers to diagnose MPM (4,8).
Positive
MALIGNANT PLEURAL MESOTHELIOMA
Malignant Pleural Mesothelioma (MPM) is a progressive, terminal disease of the pleural cavity. This tumour can be divided per their histology (2). Epithelioid is the most common mesothelioma while sarcomatoid type is the least common. The biphasic mesothelioma is a combination of the epithelioid and sarcomatoid type. The sarcomatoid mesothelioma is the lest common. Asbestos have been identified as the predominant cause of MPM (3). Asbestos is a natural silicate mineral that can be divided into serpentine and amphibole types (3, 4). Serpentine asbestos are short fibres that can be easily removed from the lung by macrophages towards airways or lymphatics (4,5). Moreover …show more content…
The most common symptoms are pleural effusion, following by non-pleuratic chest pain, dyspnea, fever, weight loss and fatigue (4). With time, pleural effusion accumulates and the pleura congeals to form a rind that encases the lung (4). The estimated range of survival after diagnosis of MPM are 7 to 17 months (3). However, the stage of the tumour cannot be used to predict the outcome of the disease. The most favourable outcomes have been associated to the epithelioid type, while the least favourable outcomes are linked to the sarcomatoid type (1,3). The clinical signs that can help producing a poor prognosis are age greater than 75 years, male gender, and pleural involvement (1,3).
DIAGNOSIS
Diagnosis of MPM is specially challenging due to the difficulty to distinguish it from benign pleural effusions and lung adenocarcinomas (4). Pleural biopsy, histopathologic analysis are the common methods used to diagnose MPM. Although histopathologic analysis is considered the gold standard diagnosis, it can be supported by ancillary techniques, such as molecular biology, electron microscopy and biomarker analysis (4,8). Immunohistochemistry (IHC) requires at least two positive immune-reactive and two negative immune-reactive markers to diagnose MPM (4,8).
Positive