Mesothelioma is a rare type of tumour. On average, this is 10-15 cases per 1 million, but in recent years the number of people has increased and continues to grow. Diagnosis and treatment issues also remain relevant because the number of mesothelioma cases reported in the literature is very small.
What is pleural mesothelioma: cancer features
Pleural mesothelioma (ICB C45.0) is a malignant tumour of the connective tissue originating from mesothelioma cells. This type of oncology is found not only in the lung area. There is also mesothelioma of the abdominal cavity, pericardium, testis, but is most commonly found in the pleura.
The pleura consists of 2 leaves: the first (visceral) is a membrane that surrounds the lungs. The outer leaf (parietal pleura) covers the chest wall and the mediastinum. There is a small space between the leaves – a pleural cavity filled with fluid.
Mesothelioma usually affects the entire visceral and parietal pleura. Because of this, there are disorders in the lungs, there are problems with the respiratory function. As the tumour grows, it can spread to adjacent structures: soft tissues and mediastinal, lungs, chest and ribs, spine, diaphragm, in the abdominal cavity. The development of the disease is rapid, so there is a very high mortality rate. mesothelioma.
In men, this pathology is diagnosed 5-6 times more often than in women!
There is also benign pleural mesothelioma that does not metastasize but is also very dangerous.
Classification of pleural mesothelioma
Pleural mesothelioma can take 2 forms:
Localized or detached (represented as a well-spaced leg knot). Diffuse (represents a large thickening of the pleural mucosa, which has no clear boundaries). From the outside, it looks like many nodes that merge with each other. Diffuse mesothelioma is much more common than localized. It is more aggressive, grows infiltratively, and can affect the organs of the mediastinum or abdominal cavity. In histological examination, it is determined by a pronounced cell polymorphism. A distinguishing feature is the secretion of mucoid substance, which results in hydrothorax.
There are the following types of pleural mesothelioma (diffuse):
- Epithelioid (50-70%).
- Sarcomatous (10-20%).
- Two phase (20-25%).
- Desmoplastic (very rare).
The localized form is represented by the fibrotic variant, and the determination of the histological variant is very important as they all have different characteristics and prognosis.
Stages of the malignant process
There are 4 stages of pleural mesothelioma:
Stage 1 Pleural Mesothelioma Does Not Extend Beyond The Ipsilateral Pleural Cavity. Visceral Pleura Is Unaffected;
Stage 2 Is Characterized By Germination Of Education In The Opposite Mediastinal Pleura. There Are 1 Of These Signs: Invasion Of The Diaphragm Muscle Tissue, Germination In The Lung Parenchyma;
In Stage 3, The Process Spreads Through The Diaphragm To The Peritoneum. There Is A Lesion Of Lymph Nodes Outside The Breast Cavity And 1 Of These Symptoms: O Pericardial Damage, O One Tumour In The Tissues Of The Chest Wall, O Germination In The Mediastinum Or Hilar Fascia;
Stage 4 Pleural Mesothelioma Is Characterized By The Presence Of Distant Metastases. The Process May Include Ribs, Mediastinals, Diaphragm, Spine, Brachial Plexus. There Is Diffuse Diffusion Through The Tissues Of The Chest, Metastases In The Lymph Nodes Of The Mediastinum, Root Of The Lungs And Breasts, Or Metastases In The Supraclavicular And Pre-Scalar LU.
What Causes Pleural Mesothelioma?
In 90% of cases, the development of malignant pleural mesothelioma is associated with human contact with asbestos. Repeated cases of this tumour have been reported in asbestos mines. It should be noted that the development of the disease does not happen immediately, but only after decades. For this reason, pleural mesothelioma is diagnosed in older men, aged 65 to 70, who used asbestos at a young age.
The highest incidence of mesothelioma has been reported in England, the US and Australia, but as asbestos is actively produced in Russia during Soviet times, scientists suggest increasing the number of patients by 2020-2025.
The reason may also be:
Other Chemical Carcinogens (Beryllium, Paraffin, Silicates);
Genetic Abnormalities In Chromosomes;
Smoking is considered a risk factor, although it is more likely to cause lung cancer.