Análisis de las técnicas invasivas diagnósticas para la confirmación anatomopatológica del mesotelioma pleural

Abstract

Background and objectiveMesothelioma is an infrequent neoplasm with a poor prognosis that is related to exposure to asbestos and whose peak incidence in Europe is estimated from 2020. Its diagnosis is complex, imaging techniques and the performance of invasive pleural techniques being essential for pathological confirmation. The different diagnostic yields of these invasive techniques are collected in the medical literature. The present work consisted of reviewing how the definitive diagnosis of mesothelioma cases in our center was reached to check if there was concordance with the data in the bibliography. Materials and methodsRetrospective review of patients with a diagnosis of pleural mesothelioma in the period 2019-2021, analyzing demographic data and exposure to asbestos, the semiology of the radiological findings and the invasive techniques performed to reach the diagnosis. ResultsTwenty-six mesothelioma cases were reviewed (22 men and 4 women). Median age 74years. Nine patients had a history of asbestos exposure. Moderate-severe pleural effusion was the most frequent radiological finding (23/26). The sensitivity of the invasive techniques was as follows: cytology 13%, biopsy without image guidance 11%, image-guided biopsy 93%, surgical biopsy 67%. ConclusionsIn our review, pleural biopsy performed with image guidance was the test that had the highest diagnostic yield, so it should be considered as the initial invasive test for the study of mesothelioma.