Mesothelioma

Mesothelioma 

Updated: 10/15/2020

© Jun Wang, MD, PhD

General features
  • Arises from mesothelial lining of pleura, peritoneum, pericardium and tunica vaginalis
  • Pleura most common location
  • More common in men, 50-80 years old
  • May occur in younger population with equal sexual distribution
  • Poor prognosis, commonly recur
Key risk factors
  • Asbestos exposure
  • Peak age 35-45 years after asbestos exposure
  • Other risk factors: Radiation, Erionite, SV40 virus
Key pathogenesis
  • Direct damage of asbestos: Toxicity, ROS production, DNA damage
  • Immune suppression
Key clinical features
  • Most common presentations: Dyspnea and nonpleuritic chest wall pain
  • Other presentations: Chest discomfort, pleuritic pain, sweat, etc
Key morphological features
Genetic abnormalities
  • P16INK4a/p14ARF
  • NF2
  • BAP1
Diagnosis
  • Radiologic studies: Pleural thickening, effusion, reduction of volume in affected thorax
  • Thoracentesis
  • Thoracoscopical biopsy
  • Serum markers (mesothelin, megakaryocyte potentiating factor)
Markers
  • Positive: Calretinin, CK5/6
  • Negative: TTF1
Treatment
  • Surgery, chemotherapy, radiation


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