Mesothelioma of the pleura ICD C45.0.

Mesothelioma of the pleura ICD C45.0.

DEFINITION:

Tumors of the major layers of the body cavities unite Mesothelioma (benign and malignant). Most often arise from the pleura.
Pleural mesothelioma is a rare disease that is more common in men around the age of 60 years.

ETIOLOGY:

More than 80% of patients are found with asbestos exposure., The time of contact with asbestos products until the onset of the disease is sometimes 30-40 years. Mechanisms of asbestos-induced oncogenesis is not well understood. It is assumed that asbestos fibers can play the role of initiator and promoter in the tumor process. as etiologic agents were studied fiber and other minerals, radiation, beryllium and others.

Anatomy:

Macroscopically distinguishes two types of malignant pleural mesothelioma - localized and diffuse. Localized tumors are most often benign, but malignant variants exist.
Typical malignant tumor of the pleura is diffuse mesothelioma. He has a very fast growth and metastasize (distracted) quickly with blood and mediastinal lymph nodes. Death occurs by engaging the vital organs in the chest.
Histological forms of pleural mesothelioma are;


1) epithelial;


2) mesenchymal;


3) mixed;


Specific feature of mesothelioma cells is the production of hyaluronic acid, which is uses for specific staining in histological examination. For histologically confirmed diagnosis is considered only obtained from the study of pleural biopsy.

Hospital:

 The main symptoms of pleural mesothelioma zlikachestveniya include: chest pain, shortness of breath with varying degrees of markedness. Pain is pleural character, constantly amplified cough and localized in the chest half. It can become very strong unbearable because of the abundance of receptors bolevite pleura and infiltration of the tumor in the chest wall. Shortness of breath as a result of the restriction, because the compression coverage of the lung. Pleural effusion is more than 95% of patients. Furthermore, a cough that is painful without phlegm, and establishes fever and weight loss are common symptoms. In advanced stages of the disease show symptoms of compression and sprouting of mediastinal organs and structures: difficulty swallowing (disgfagiya), pericardial effusion, rhythm and conduction disturbances, paresis of the diaphragm syndrome empty upper vein.

DIAGNOSIS:

 It includes the following methods:


1) Radiography (butt and profile);


2) pleural puncture evacuation of effusion and biochemical study of punktata;


3) Scanner chest - shaped method of choice


4) Nuclear magnetic resonance - provides additional information about the germination of pleural mesothelioma;


5) ECG (echocardiogram) and ultrasonography (with involvement of the pericardium and heart);


6) pleural needle biopsy;


7) Video-assisted torakoskopiya (view of the chest cavity) and pleural tumor biopsy


8) and laparoscopy Mediastinoskopiya


The diagnosis of malignant pleural mesothelioma is considered valid after imunihistohimichno and / or electron microscopic confirmation.

CLASSIFICATION:


T 1 bis - parietal pleura covers the relevant country.


T1b - spans parietal and visceral pleura on the same side;


T2 + lung and diaphragm;


T3 + limited coverage of the chest wall, thoracic fascia incompletely covered pericardium;


T4 - includes bones, peritoneum (membrane that surrounds the abdominal organs in the abdominal cavity), myocardium, mediastinum, pericardium around (the sac that surrounds the heart);

TREATMENT:

The main methods applied in pleural mesothelioma are operative removal, radiation therapy and chemotherapy with Cisplatin, Doxorubicin and others.