Malignant Pleural Mesothelioma

Malignant pleural mesothelioma is a rare disease in which cancer cells develop in the pleura (the protective sac covering the lungs). The main risk factor for malignant pleural mesothelioma is exposure to asbestos. Most people with the disease were exposed to asbestos in the workplace. Possible signs of malignant pleural mesothelioma include shortness of breath and pain under the rib cage. It can be difficult to distinguish between malignant pleural mesothelioma and lung cancer, so it may be necessary to examine the inside of the chest to confirm the diagnosis.

 

Malignant Pleural Mesothelioma: An Overview

Mesothelioma is a benign (noncancerous) or malignant (cancerous) tumor affecting the mesothelium, which is a type of protective sac that covers internal organs. Most cases of mesothelioma begin in the pleura (lining around the lungs) or peritoneum (the lining around the abdomen).
 
Malignant pleural mesothelioma is a type of mesothelioma in which cancer cells begin to grow in the pleura.
 
Most people who develop malignant pleural mesothelioma have worked on jobs where they inhaled asbestos particles.
 

Risk Factors for Malignant Pleural Mesothelioma

Being exposed to asbestos can affect the risk of developing malignant pleural mesothelioma. Many people with malignant pleural mesothelioma have worked or lived in places where they inhaled or swallowed asbestos. After being exposed to asbestos, it usually takes a long time for malignant pleural mesothelioma to occur.
 
Other risk factors for malignant pleural mesothelioma include the following:
 
  • Living with a person who works near asbestos
  • Being exposed to a certain virus.
     

Symptoms of Malignant Pleural Mesothelioma

Malignant pleural mesothelioma symptoms usually result from an accumulation of fluid in the pleura. These pleura mesothelioma symptoms often consist of:
 
  • Shortness of breath
  • Pain in the chest or under the ribcage.
     
Keep in mind that other more common, less serious conditions can cause similar symptoms. If you are experiencing any possible malignant pleural mesothelioma symptoms, visit your healthcare provider so that the problem can be diagnosed and treated.
 

Diagnosing Malignant Pleural Mesothelioma

Sometimes it is hard to tell the difference between malignant pleural mesothelioma and lung cancer, so tests are performed to examine the inside of the chest to accurately diagnose the condition.

 

The following tests and procedures may be used to diagnose malignant pleural mesothelioma:
 
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits, exposure to asbestos, past illnesses, and treatments will also be taken.
     
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
     
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
o The number of red blood cells, white blood cells, and platelets.
o The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
o The portion of the blood sample made up of red blood cells.
  • Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.
     
  • Biopsy: The removal of cells or tissues from the pleura so they can be viewed under a microscope by a pathologist to check for signs of malignant pleural mesothelioma. Procedures used to collect the cells or tissues include the following:
o Fine-needle aspiration biopsy. The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. This procedure is also called a needle biopsy.
 
o Thoracoscopy. An incision (cut) is made between two ribs and a thoracoscope (a thin, lighted tube) is inserted into the chest.
o Peritoneoscopy. An incision is made in the abdominal wall and a peritoneoscope (a thin, lighted tube) is inserted into the abdomen.
o Laparotomy. An incision is made in the wall of the abdomen to check the inside of the abdomen for signs of disease.
o Thoracotomy. An incision is made between two ribs to check inside the chest for signs of disease.
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.
     
  • Cytologic exam: An exam of cells under a microscope (by a pathologist) to check for anything abnormal. For malignant pleural mesothelioma, fluid is taken from around the lungs. A pathologist checks the cells in the fluid.
     
After is malignant pleural mesothelioma diagnosis is confirmed, additional tests will be performed in order to determine the stage of the cancer.
 

Treatment Options for Malignant Pleural Mesothelioma

Malignant pleural mesothelioma treatment options may include:
 

 

Malignant Pleural Mesothelioma: Summary

The following is a summary of key points about malignant pleural mesothelioma:
 
  • Malignant pleural mesothelioma is a disease in which malignant (cancer) cells form in the lining of the chest
  • Being exposed to asbestos can affect the risk of developing malignant pleural mesothelioma
  • Possible signs of malignant pleural mesothelioma include shortness of breath and pain under the rib cage
  • Tests that examine the inside of the chest are used to find and diagnose malignant pleural mesothelioma
  • Certain factors affect prognosis (chance of recovery) and treatment options for malignant pleural mesothelioma (see Mesothelioma Survival Rate).
     
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD