Diffuse Malignant Mesothelioma

Abstract

Diffuse malignant mesothelioma (DMM) is an uncommon cancer with great clinical significance because it currently remains an incurable disease, and most patients die within months after diagnosis. Although DMM incidence is leveling off or decreasing in developed countries because of the strict control of asbestos use, it is increasing in countries without adequate asbestos control. In some settings, benign, reactive mesothelial hyperplasias and organizing pleuritis can be difficult to differentiate from DMM and vice versa, and the variety of DMM's histopathologic features generates an extensive list of differential diagnoses with other malignancies, particularly, metastatic malignancies, which are more frequent in the pleura than are primary malignancies. These two issues are the topic of discussion in this review, along with a brief presentation of a case of DMM that presented in a 66-year-old man with recurrent, right pleural effusions, and in whom, diagnosis of DMM had not been suspected clinically, radiographically, surgically, grossly, or initially, on frozen section. It was not until focal invasion into the skeletal muscle was discovered on permanent sections that a diagnosis of DMM could be established.

Malignant Mesothelioma Diagnosis

“…The key indicator of malignancy remains invasion of preexisting tissue, particularly adipose tissue. [6][7][8][9] One must be careful not to mistake ''fake fat,'' which is an artifact and is S100 negative (Figure 1, A and B), for real invasion into preexisting adipose tissue. 10 Two antibodies, glucose transporter 1 (GLUT-1) and insulin-like growth factor II messenger RNA-binding protein 3 (IMP3), have recently been shown to have utility in differentiating benign from malignant mesothelioma, independently from tissue invasion.…”

Malignant pleural mesothelioma with constrictive pericarditis as the first manifestation: A case report

“…Mesothelioma is a rare malignancy that originates in the plasma membrane and can occur in the pleura, pericardium, abdomen, and spine 1–4 . Pleural mesothelioma (PM) is the most common of mesotheliomas, with chest pain and dyspnea as the initial symptoms 5 . Progressive worsening of chest pain and dyspnea as the disease progresses.…”

“…1 , 2 , 3 , 4 Pleural mesothelioma (PM) is the most common of mesotheliomas, with chest pain and dyspnea as the initial symptoms. 5 Progressive worsening of chest pain and dyspnea as the disease progresses. However PM rarely involves the pericardium, and pericardial involvement in PM is mainly caused by direct tumor invasion.…”

Intrapleural port systems as a technology for the control of recurrent metastatic exudative pleurisy. first experience

“…[10][11][12]. Диагностическая и лечебная тактика метастатического плеврита подверглась существенным изменениям за последние годы и продолжает совершенствоваться благодаря появлению новых диагностических алгоритмов, а также выбору подходов комплексного и комбинированного лечения, включающих сочетание химио-иммунотерапии и внутриплеврального воздействия [13][14][15][16][17][18][19][20][21]. Исходя из рекомендаций Российского общества клинической онкологии, при рецидиве метастатического плеврита с частотой более 3 раз в месяц показано выполнение плевродеза, искусственного созданного асептического воспаления плевры, с целью облитерации плевральной полости для купирования рецидивов метастатического плеврита [22,23].…”