小结
定义
病史和体格检查
关键诊断因素
- 家族史
- 石棉接触史
- 60~85 岁
- 呼吸短促
- 呼吸音减弱
- 叩诊浊音
其他诊断因素
- 男性
- 胸痛
- 咳嗽
- 全身性症状
- 腹胀和/或腹痛
危险因素
- 石棉暴露
- 房屋维修和改造期间的石棉接触
- 60~85 岁
- 男性
- 放射暴露
- 遗传易感性
- 猿猴病毒 40 (SV-40)
诊断性检查
首要检查
- 胸部 X 线检查
- 胸部和上腹部增强 CT 扫描
需考虑的检查
- 胸腔穿刺术
- 胸膜活检
- 电视辅助胸腔镜手术 (VATS)
- 免疫组织化学检查
- 胸部 MRI
- PET 扫描
- 颈部纵隔镜检查
- 肺功能检查 (PFT)
- 全血细胞计数 (FBC）
- 基础代谢检查
治疗流程
可动手术的疾病
不能动手术或复发性疾病
撰稿人
作者
Anish Thomas, MD, MBBS
Staff Clinician
Center for Cancer Research
Thoracic and Gastrointestinal Oncology Branch
National Cancer Institute
Bethesda
MD
利益声明
AT declares that he has no competing interests.
Jaydira del Rivero, MD
Medical Oncology Branch
Center for Cancer Research
National Cancer Institute
Bethesda
MD
利益声明
JdR declares that he has no competing interests.
Mary Hesdorffer, MS, APRN
Nurse Practitioner
Executive Director
Mesothelioma Applied Research Foundation
Alexandria
VA
利益声明
MH declares that she has no competing interests.
鸣谢
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.
利益声明
RT and CRK declare that they have no competing interests.
同行评议者
Marc de Perrot, MD, MSc
Associate Professor of Surgery
University of Toronto
Division of Thoracic Surgery
Toronto General Hospital
Ontario
Canada
利益声明
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
利益声明
NJV is a past chair of a US-based mesothelioma foundation. NJV is an author of a number of references 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
利益声明
TT declares that he has no competing interests.
鉴别诊断
- 良性反应性间皮增生
- 良性石棉相关性胸膜反应
- 非小细胞肺癌
更多 鉴别诊断指南
- NCCN 肿瘤学临床实践指南：恶性胸膜间皮瘤
- 治疗恶性胸膜间皮瘤
更多 指南
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