Summary
Definition
History and exam
Key diagnostic factors
- family history
- history of asbestos exposure
- age between 60 and 85 years
- shortness of breath
- diminished breath sounds
- dullness to percussion
Other diagnostic factors
- male sex
- chest pain
- cough
- constitutional symptoms
- abdominal distention and/or pain
Risk factors
- asbestos exposure
- age 60 to 85 years
- asbestos exposure during home maintenance and renovation
- male sex
- radiation exposure
- genetic predisposition
- simian virus 40 (SV-40)
Diagnostic tests
1st tests to order
- CXR
- CT chest and upper abdomen (with contrast)
Tests to consider
- thoracentesis
- pleural biopsy
- video-assisted thoracoscopic surgery (VATS)
- immunohistochemistry
- chest MRI
- fluorodeoxyglucose (FDG) PET/CT scan
- cervical mediastinoscopy
- pulmonary function tests
- CBC
- basic metabolic panel
Emerging tests
- diagnostic biomarkers
Алгоритм лечения
resectable disease
unresectable or recurrent disease
Составители
Авторы
Idrees Mian, MD
Hematologist Oncologist
Kaiser Permanente
Oncology
Washington
DC
Раскрытие информации
IM declares he has no competing interests.
Выражение благодарностей
Dr Idrees Mian would like to gratefully acknowledge Dr Jaydira del Rivero, Dr Anish Thomas, Mrs Mary Hesdorffer, Dr Robert Taub, and Dr Chris R. Kelsey, the previous contributors to this topic.
Раскрытие информации
AT, JdR, MH, RT, and CRK declare that they have no competing interests.
Рецензенты
Marc de Perrot, MD, MSc
Associate Professor of Surgery
University of Toronto
Division of Thoracic Surgery
Toronto General Hospital
Ontario
Canada
Раскрытие информации
MdP is an author of a reference cited in this topic.
Nicholas J. Vogelzang, MD
Chair and Medical Director
Developmental Therapeutics
Co-Chair
GU Committee
US Oncology Research
Comprehensive Cancer Centers of Nevada
Las Vegas
NV
Declarações
NJV is a past chair of a US-based mesothelioma foundation. NJV is an author of a reference cited in this topic.
Tom Treasure, MD, MS FRCS, FRCP
Professor of Cardiothoracic Surgery (Honorary)
Clinical Operational Research Unit
Department of Mathematics
University College London
London
UK
Declarações
TT is an author of a reference cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: mesothelioma: pleural [internet publication].Texto completo
Woolhouse I, Bishop L, Darlison L, et al. British Thoracic Society guideline for the investigation and management of malignant pleural mesothelioma. Thorax. 2018 Mar;73(suppl 1):i1-30.Texto completo Resumo
Popat S, Baas P, Faivre-Finn C, et al. Malignant pleural mesothelioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2022 Feb;33(2):129-42.Texto completo Resumo
Kindler HL, Ismaila N, Armato SG 3rd, et al. Treatment of malignant pleural mesothelioma: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2018 May 1;36(13):1343-73.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Benign reactive mesothelial hyperplasia
- Benign asbestos-related pleural reactions
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