Abstract
Exposure to asbestos can lead to asbestosis or malignancy 10-40 years after initial exposure [1]. Although its use has been banned in multiple countries, past occupational exposure leads to most cases that we see in present time. Malignant mesothelioma is an insidious and rare neoplasm that can arise from mesothelial surface cells, being Malignant Pleural Mesothelioma (MPM) the most common type. Lifetime risk of developing mesothelioma among asbestos workers can be as high as 10 percent and latency period is approximately 30-40 years since time of exposure to development of disease [2]. Annual incidence in the united states is approximately 3,300 cases per year [3]. Median overall survival of patients with advanced unresectable disease is approximately 12 months [4]. Clinical suspicion should arise in patients with previous exposure to asbestos who present with pleural thickening and/or effusion with associated respiratory symptoms. Most symptoms are nonspecific such as chest pain, dyspnea, cough and night sweats. Initial evaluation includes chest x-ray, contrast enhanced CT of the chest to find pleural abnormalities, thoracentesis and closed pleural biopsy. However, difficulties establishing diagnosis have been illustrated on studies where thoracentesis and pleural fluid cytology only yields diagnosis in 26% of cases. The diagnosis, then, is established by morphologic and immunohistochemistry findings of cytologic and surgical specimens.
Highlights
Exposure to asbestos can lead to asbestosis or malignancy *Correspondence to Author: 10-40 years after initial exposure [1]
Immunohistochemical expression coupled with the radiologic impression compatible with the diagnosis of malignant mesothelioma
Occupational asbestos exposure has decreased positron emission tomography with computed but remains a significant problem due previous tomography is obtained as part of staging exposure years before
Summary
Occupational asbestos exposure has decreased positron emission tomography with computed but remains a significant problem due previous tomography is obtained as part of staging exposure years before. A minority of patients are mesothelioma in the US has been in decline, candidates for surgical resection, reason why secondary to asbestos exposure control [5]. Exposure, characterized by pleural plaques and diffuse pleural thickening. These are benign findings due to asbestos exposure, it is important to exclude malignancy in view of these findings. Most common radiographic findings include unilateral large pleural effusion, pleural mass or diffuse pleural thickening, pleural plaques and/or calcifications. When patient presents with symptomatic pleural effusion initial thoracentesis should be performed and pleural fluid cytologic examination should follow.
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