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 distension and/or pain
Risk factors
- asbestos exposure
- asbestos exposure during home maintenance and renovation
- age 60 to 85 years
- male sex
- radiation exposure
- genetic predisposition
- simian virus 40 (SV-40)
Diagnostic investigations
1st investigations to order
- chest x-ray
- CT scan of the chest and upper abdomen with intravenous contrast
Investigations to consider
- thoracentesis
- pleural biopsy
- video-assisted thoracoscopic surgery (VATS)
- immunohistochemistry
- chest MRI
- PET scan
- cervical mediastinoscopy
- pulmonary function tests
- FBC
- basic metabolic panel
Treatment algorithm
Contributors
Authors VIEW ALL
Staff Clinician
Center for Cancer Research
Thoracic and Gastrointestinal Oncology Branch
National Cancer Institute
Bethesda
MD
Disclosures
AT declares that he has no competing interests.
Medical Oncology Branch
Center for Cancer Research
National Cancer Institute
Bethesda
MD
Disclosures
JdR declares that he has no competing interests.
Nurse Practitioner
Executive Director
Mesothelioma Applied Research Foundation
Alexandria
VA
Disclosures
MH declares that she has no competing interests.
Dr Anish Thomas, Dr Jaydira del Rivero, and Mrs Mary Hesdorffer would like to gratefully acknowledge Dr Robert Taub and Dr Chris R. Kelsey, the previous contributors to this topic. RT and CRK declare that they have no competing interests.
Peer reviewers VIEW ALL
Associate Professor of Surgery
University of Toronto
Division of Thoracic Surgery
Toronto General Hospital
Ontario
Canada
Disclosures
MdP is an author of a reference cited in this topic.
Chair and Medical Director
Developmental Therapeutics
Co-Chair
GU Committee
US Oncology Research
Comprehensive Cancer Centers of Nevada
Las Vegas
NV
Disclosures
NJV is a past chair of a US-based mesothelioma foundation. NJV is an author of a number of references cited in this topic.
Professor of Cardiothoracic Surgery (Honorary)
Clinical Operational Research Unit
Department of Mathematics
University College London
London
UK
Disclosures
TT declares that he has no competing interests.
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