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Diagnosis and Staging of Mesothelioma

 Mesothelioma is a rare and very aggressive tumor that affects the pleura, and its main cause is exposure to asbestos, a mineral used in construction whose use was banned four decades ago.

Diagnosis and staging of mesothelioma

Because the symptoms of this tumor are very unspecific, findings of suspected mesothelioma appear radiology, after checking history of exposure to asbestos. 


The various radiological tests: CT or MRI are useful for the extension study or to determine resectability (operability) or injury. PET is superior to CT setting distant disease, but it has limitations in the locoregional staging.

Obtaining a sample for pathological diagnosis of mesothelioma can be thoracentesis (obtaining pleural fluid) for subsequent cytological, but the profitability of this test is not more than 33%. 

The pleural biopsy to obtain a tissue cylinder can be done blind (50% yield), or open by thoracoscopy (VATS), or thoracotomy, reaching up to 95% return; also reports the extent of the disease to the diaphragm, pericardium, chest wall and lymph nodes. This biopsy involves a risk of spreading the chest wall up to 10% of patients.

For mesothelioma staging the TNM system is used, in its 2002 update.


There are many prognostic factors that influence survival (advanced stage) such as: the general condition of the patient, chest pain, dyspnea, thrombocytosis (platelets> 400000), weight loss, elevated LDH (> 500 IU / l), pleural involvement, (compared to pericardium or peritoneum), anemia, leukocytosis, older than 75 years, and so on.
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