Malignant pleural Mesothelioma

Patients with pleural mesothelioma usually complain of shortness of breath that occurs as a result of accumulation of pleural effusion, or pain if the tumor spreads to the surrounding nerve trunks. It is also observed in patients with low-grade fever, weakness, fatigue.

Diagnostics
Since the main symptom of pleural mesothelioma - accumulation of fluid in the pleural cavity, the first thing that needs to be done - to evacuate the liquid and carry out cytology exudate.

Before preparing the necessary cytological preparations it is recommended to centrifuge the liquid to increase the concentration of malignant cells per unit volume. This type of study, unfortunately, is not always informative for accurate diagnosis of pleural mesothelioma. If using it could not verify the disease, after the evacuation of the fluid must perform either plevroskopiyu or videoassotsiirovannuyu thoracoscopy or thoracotomy with pleural biopsy. The resulting material is sent to histological or immunohistochemical study.



According to the structure of the following types of pleural mesothelioma:

mixed;
sarcomatoid;
epithelium (the most common type - about 60%).
Pleural mesothelioma is not usually metastasizes to distant organs. However, unfortunately, many patients come for treatment to have a state of neglect, which is manifested in the expression of the tumor locally germination. But in spite of such features of the disease, with the primary diagnosis is important to examine, and other organs for the presence of malignant cells. This can conduct abdominal ultrasound, including liver, chest X-rays do. In some cases, it is shown holding the whole body PET.

Treatment
In the early stages of the disease can be extrapleural pneumonectomy. This operation involves the removal of a single unit consisting of lung, pleura, pericardium and diaphragm parts.

If pleural mesothelioma patient has a pronounced local distribution, the palliation is possible to make a partial resection of the pleura. This would reduce pain and dyspnea.

Due to peculiarities of tumor development, as well as the rarity of his early detection of the use of radiation therapy and surgery are extremely limited. Usually, for the treatment of pleural mesothelioma chemotherapy is used. Thus administration of drugs is possible both intravenous and intrapleural or a combination of both methods. Good addition to the treatment - installation of intrapleural port, through which the evacuation of the pleural effusion, as well as the introduction of chemotherapy. In most cases, use of platinum derivatives, doxorubicin, vinorelbine, gemcitabine, and some other means in combination or mono.

Evaluating the effectiveness of the treatment is carried out every 2-3 months.

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