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Mesotelioma

Última revisão das evidências: 30 Apr 2026
Última atualização do tópico: 19 Nov 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • história familiar
  • história de exposição a asbesto
  • idade entre 60 e 85 anos
  • dispneia
  • murmúrio vesicular diminuído
  • macicez à percussão
Detalhes completos

Outros fatores diagnósticos

  • sexo masculino
  • dor torácica
  • tosse
  • sintomas constitucionais
  • distensão e/ou dor abdominal
Detalhes completos

Fatores de risco

  • exposição ao asbesto
  • idade entre 60 e 85 anos
  • exposição ao asbesto durante a reforma e manutenção de casas
  • sexo masculino
  • exposição à radiação
  • predisposição genética
  • vírus símio 40 (SV-40)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • radiografia torácica
  • TC do tórax e abdome superior (com contraste)
Detalhes completos

Investigações a serem consideradas

  • toracocentese
  • tomografia por emissão de pósitrons/tomografia computadorizada (PET/TC)
  • biópsia pleural
  • cirurgia toracoscópica videoassistida (CTVA)
  • imuno-histoquímica
  • Teste de linha germinativa
  • ressonância nuclear magnética (RNM) do tórax
  • mediastinoscopia cervical
  • testes de função pulmonar
  • Hemograma completo
  • perfil metabólico básico
Detalhes completos

Novos exames

  • biomarcadores diagnósticos

Algoritmo de tratamento

AGUDA

doença ressecável

doença irressecável ou recorrente

Colaboradores

Autores

Hedy Kindler, MD

​​Professor of Medicine

Associate Dean for Clinical Science Research, Human Subjects

The University of Chicago, Biological Sciences Division

Section of Hematology/Oncology

Chicago

Declarações

HK declares she has no competing interests.

Agradecimentos

Dr Hedy Kindler would like to gratefully acknowledge Dr Idrees Mian​, Dr Jaydira del Rivero, Dr Anish Thomas, Mrs Mary Hesdorffer, Dr Robert Taub, and Dr Chris R. Kelsey, the previous contributors to this topic.

Declarações

IM, JdR, AT, MH, RT, and CRK declare that they have no competing interests.

Revisores

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.

Tom Treasure, MD, MS FRCS, FRCP

Professor of Cardiothoracic Surgery (Honorary)

Clinical Operational Research Unit

Department of Mathematics

University College London

London

UK

Раскрытие информации

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.

Список литературы

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Основные статьи

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: mesothelioma: pleural [internet publication].Полный текст

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.Полный текст  Аннотация

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.Полный текст  Аннотация

Kindler HL, Ismaila N, Bazhenova L, et al. Treatment of pleural mesothelioma: ASCO guideline update. J Clin Oncol. 2025 Mar 10;43(8):1006-38.Полный текст  Аннотация

Статьи, указанные как источники

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