[Epidemiology and etiology of mesothelioma]

The early diagnosis of mesothelioma rests on very common clinical evidence, including pleuritis of recent onset, history of contact with asbestos chest pain, often moderate loss of weight and slight changes in old pleural images. The sensitivity of formal diagnostic examinations is 23 p. 100 for pleural fluid cytology, 24 p. 100 Adams' needle biopsy and 93 p. 100 for thoracoscopy, where the only negative results are obtained in patients with adhesive pleuritis. Prognosis depends on several factors, the most favourable ones being the histological type of the lesion (epithelial or mixed), the fact that it is limited to the parietal or diaphragmatic pleura and, on the patient's side and accessorily: female sex, lack of exposure to asbestos, age under 50, good general condition and absence of chest pain.