Mesothelioma Pathology
Mesothelioma
can be classified under three major histological types:
-
Epithelial
or tubulopapillary, the most frequent (50 to 70% of cases)
-
Mesenchymal
or fibrosarcomatous, the least common (7 to 20% of cases)
-
Mixed
or biphasic, intermediate in frequency (20 to 35% of cases).
The mixed type is the most characteristic, containing both
epithelial and mesenchymal elements
-
A
remarkable property of the mesothelial cell is the
production of hyaluronic acid
Signs
and Symptoms
The
onset of mesothelioma is usually insidious; a common presenting
symptom is persistent localized pain.
Pleural
Mesothelioma
-
Varying degree
of chest pain or dyspnea.
-
Pleural
effusion is present initially in up to 95% of cases.
-
Later,
tumor growth usually results in complete obliteration of the
pleural space and encasement of the lung.
-
Cough,
weight loss, and fever are not uncommon. Clubbing of fingers
is seen in only few cases.
-
Mediastinal
invasion results in dysphagia, phrenic nerve paralysis,
pericardial effusion, and superior vena cava syndrome can
occur. Spontaneous pneumothorax or hydropneumothorax and
Horner's syndrome (ptosis, pupillary miosis and facial
anhidrosis) can some time occur
-
Progressive
invasion of the chest wall often leads to intractable pain.
-
Median
survival is about 10 to 17 months from onset of symptoms and
9 to 13 months from diagnosis. 5-year survival probabilities
is just 3%.
Peritoneal
Mesothelioma
-
Pain
and abdominal distention with ascites are almost constant in
patients with peritoneal mesothelioma.
-
Other
clinical findings include nausea and vomiting, bowel
obstruction
-
Abdominal
and pelvic masses, edema of the lower extremities, fever,
hernia, hydrocele, and obstructive uropathy.
-
Median
survival is about 10 months from onset of symptoms and 7
months from diagnosis.
|