The most common symptoms of pleural mesothelioma are Lessing of breath and chest pain. They are observed in 60-80% of patients. The pain often radiates at different points, so it is confused with neuralgia, cholecystitis, angina, etc.
The secondary characters are:
- Weight Loss (In 30% Of Patients);
- Fever (30%);
- Cough (10%);
- General Weakness, Headache, Chills.
The signs of the disease are very similar to lung cancer. A complete histological examination is required to differentiate the tumor.
When nodular pleural mesothelioma symptoms may be absent for a long time, so it is found accidentally. Diffuse grows rapidly and is accompanied by acute symptoms.
- Local symptoms of pleural mesothelioma include:
- Dysphagia And Hoarseness (With Tracheal Compression);
- Horner’s Syndrome (With Sympathetic Nervous System Damage). It Includes Retraction Of The Eyeball, Ptosis, Miosis And Other Ocular Dysfunctions;
- Initial Vena Cava Syndrome (Occurs When The Tumor In The Superior Vena Cava Squeezes Or Emerges). This Phenomenon Is Accompanied By Blue Skin And Mucous Membranes, Headache, Dizziness, Swelling Of The Face;
- Tachycardia, Dyspnoea, Cyanosis In The Nasolabial Triangle And Other Signs Of Cardiovascular Failure, As Well As Cardiac Pain Are Signs Of Pericardial Or Myocardial Taste.
- Hydrothorax (pleural effusion), which is characterized by fluid accumulation in the pleural cavity, is often observed in mesothelioma. At the same time, respiratory failure increases, cyanosis and peripheral edema appear.
Diagnosis of the disease
Diagnosis of pleural mesothelioma begins with an external examination and collection of patient complaints. The doctor definitely needs to understand the conditions in which the patient has worked before to reveal the possibility of contact with asbestos. Laboratory tests require standard blood and urine tests. Possibly the presence of leukocytosis and thrombocytosis in the blood, as well as elevated levels of alkaline phosphatase. In the blood test for lung tumours, caletinin, vimentin, mesothelin were determined, but in small quantities. The doctor then prescribes a chest radiography or ultrasound. With the help of radiography you can see the following deviations:
- Pleural Effusion;
- Thickening Of The Parietal Pleura;
- Displacement Of The Mediastinum.
More accurate information on tumors of the pleura and lungs enables computed tomography (CT). In addition to the data that radiography, CT, shows thickening of the interlobar cracks, tumor masses around the lung, reduction in the size of hemitorax. The disadvantage of this technique is the inability to adequately assess the condition of the mediastinal lymph nodes.
Magnetic resonance imaging (MRI) is more appropriate to clarify the spread of cancer in soft tissue. Positron emission tomography (PET) is performed to identify lymph node metastases and distant organs. It is very accurate and able to indicate a tumor that has just started to appear.
One of the most important methods for examining the pleural cavity is thoracoscopy. It includes an instrumental examination of the pleural cavities with a thoracoscope. It is inserted by incision into the soft tissues under anesthesia. There may be several openings to see all the necessary areas and to visually assess the presence of metastases. Biopsy material is often taken during thoracoscopy.
Methods for the diagnosis of pleural mesothelioma
The use of such methods for the diagnosis of pleural mesothelioma such as CT, MRI and PET cannot accurately determine the stage of the disease. For this purpose, the PET-CT method was recently invented, but it does not provide a 100% guarantee of a correct diagnosis. Therefore, morphological diagnosis is mandatory for treatment planning.
A pleural biopsy is taken from the patient and histological analysis of the sample obtained. The procedure is performed with a needle, but the thoracoscopic biopsy provides more accurate data. Immunohistochemistry is required to resolve the diagnosis in addition to histological analysis.
In addition, according to the testimony made:
- Cytological Examination Of The Pleural Fluid;
- Mediastinoscopy (Surgical Incision And Palpar Inspection Of Paratracheal And Tracheobronchial Lymph Nodes, Trachea, Large Vessels);
- Laparoscopy (Instrumental Examination Of The Abdominal Cavity).
Before the patient’s treatment an ECG or echocardiography and perfusion scintigraphy are performed. In some cases, catheter studies of the heart and cardiopulmonary test are required