Malignant Pleural Mesothelioma

Malignant pleural mesothelioma is a rare disease in which cancer cells develop in the protective sac covering the lungs. The main risk factor for this condition is exposure to asbestos. Possible signs include shortness of breath and pain under the rib cage. It can be difficult to distinguish between malignant pleural mesothelioma and lung cancer, so it may be necessary to examine the inside of the chest to confirm the diagnosis.

What Is Malignant Pleural Mesothelioma?
Mesothelioma is a benign (noncancerous) or malignant (cancerous) tumor affecting the mesothelium, which is a type of protective sac that covers internal organs. Most cases begin in the pleura (lining around the lungs) or peritoneum (the lining around the abdomen).

Malignant pleural mesothelioma is a type of mesothelioma in which cancer cells begin to grow in the pleura. Most people who develop this condition have worked on jobs where they inhaled asbestos particles.

Risk Factors for the Condition
Being exposed to asbestos can affect the risk of developing malignant pleural mesothelioma. Many people with the disease have worked or lived in places where they inhaled or swallowed asbestos. After asbestos exposure, it usually takes a long time for symptoms of the condition to occur.

Other risk factors for malignant pleural mesothelioma include:

Living with a person who works near asbestos
Being exposed to a certain virus.

Symptoms of Malignant Pleural Mesothelioma
Malignant pleural mesothelioma symptoms usually result from an accumulation of fluid in the pleura. These symptoms often consist of:

Shortness of breath
Pain in the chest or under the ribcage.

Keep in mind that other more common, less serious conditions can cause similar symptoms. Therefore, if you are experiencing any possible symptoms, visit your healthcare provider so that the problem can be properly diagnosed and treated.

How Is It Diagnosed?
Sometimes it is hard to tell the difference between malignant pleural mesothelioma and lung cancer, so tests are performed to examine the inside of the chest to accurately diagnose the condition.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the person's health habits, exposure to asbestos, past illnesses, and treatments will also be taken.

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:

The number of red blood cells, white blood cells, and platelets
The amount of hemoglobin (the protein that carries oxygen) in the red blood cells
The portion of the blood sample made up of red blood cells.

Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.

Biopsy: The removal of cells or tissues from the pleura so they can be viewed under a microscope by a pathologist to check for signs of malignant pleural mesothelioma. Procedures used to collect the cells or tissues include the following:

Fine-needle aspiration biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. This procedure is also called a needle biopsy.

 Thoracoscopy: An incision (cut) is made between two ribs, and a thoracoscope (a thin, lighted tube) is inserted into the chest.

Peritoneoscopy: An incision is made in the abdominal wall and a peritoneoscope (a thin, lighted tube) is inserted into the abdomen.

Laparotomy: An incision is made in the wall of the abdomen (stomach) to check the inside of the abdomen for signs of disease.

Thoracotomy: An incision is made between two ribs to check inside the chest for signs of disease.

Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.

Cytologic exam: An examination of cells under a microscope by a pathologist to check for anything abnormal. When checking for malignant pleural mesothelioma, fluid is taken from around the lungs. A pathologist checks the cells in the fluid.

After a malignant pleural mesothelioma diagnosis is confirmed, additional tests will be performed in order to determine the stage of the cancer.

Treatment Options
Treatment options for malignant pleural mesothelioma may include:

Surgery (see Mesothelioma Surgery)
Radiation therapy (see Mesothelioma Radiation)
Chemotherapy (see Mesothelioma Chemotherapy).

Key Facts on Malignant Pleural Mesothelioma
The following is a summary of key points to keep in mind about malignant pleural mesothelioma:

Malignant pleural mesothelioma is a disease in which malignant (cancerous) cells form in the lining of the chest
Being exposed to asbestos can affect the risk of developing this disease
Possible signs include shortness of breath and pain under the ribcage
Tests that examine the inside of the chest are used to find and diagnose malignant pleural mesothelioma
Certain factors affect prognosis (chance of recovery) and treatment options (see Mesothelioma Survival Rate).

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