Diffuse Malignant Mesothelioma
Diffuse Mesothelioma is a malignant tumor more common than localized but have little impact. It is estimated that around 15-18 cases per million occur annually, most often in males and in the sixth decade of life. It has been described as etiologic agent of this cancer to asbestos exposure that has a long latency period (more than 20 years), so it is expected that the incidence does not decrease for several years in which case periods are detected in the there was no right to prevent exposure to asbestos. Of the various types of existing asbestos fibers, which has been linked directly to this type of cancer is crocidolite. Sometimes, however, is impossible to prove exposure to mineral in people suffering from diffuse mesothelioma. There are also other possible etiologic factors among which exposure to radiation.
From the standpoint of pathological form of mesothelioma from mesothelial or subserosal multipotential cells and can lead to a variety epithelial, sarcomatous, or mixed between the two. The epithelial variety has large similarities with pleural metastatic adenocarcinoma, so that in practice it is very difficult to distinguish a tumor from another. The immunohistochemical studies (antibodies against cytokines high and low molecular weight, embryonal carcinoma antigen) and electron microscopy are essential to establish this distinction.
Pleural mesothelioma takes multiple nodular growth with a tendency to coalesce and invade the visceral pleura from of the wall which is the first seat. The lung is physically trapped by the tumor masses are introduced into the hilum of the lung, chest wall, diaphragm, mediastinum and contralateral hemithorax. A classification according to its extension.
The clinical manifestations are usually inconspicuous in the early stages of the disease. Chest pain is very intense and is present in the vast majority of occasions. Dyspnea is also very important as the tumor grows, it traps the lung and pleural effusion occurs. The patient’s general condition deteriorates intensively with significant constitutional symptoms and weight loss. Auscultation reveals a decrease or abolition of breath sounds and can be found on the chest wall mass and, more rarely, supraclavicular or cervical lymphadenopathy. Paraneoplastic manifestations can be found (autoimmune hemolytic anemia, hypoglycemia, antidiuretic hormone secretion) but are rare. (more…)
Studies in the United States,