[Pleural mesothelioma: a clinicopathologic study of 42 cases]

Forty two cases of pleural mesothelioma were reported. Macroscopic findings showed that 10 were localized and 32 diffuse. Histological diagnosis revealed 4 benign fibrous tumors and 38 malignant mesothelioma (epithelial type in 25, sarcomatous in 6, and mixed in 7). The main clinical manifestations of malignant mesothelioma were chest pain and dyspnea. The most frequent chest radiographic signs were nodular pleural thickening, irregular thickening of interlobar fissures, a dominant mass and pleural effusion. This disease was usually misdiagnosed as tuberculous pleurisy, lung cancer and metastatic pleural tumors. X-ray examination and CT scan were helpful in the diagnosis of the disease. Thoracoscopy is currently a suitable diagnostic method for pleural mesothelioma. Surgical management and chemotherapy were carried out in 31 cases. 3-year survival rate in 38 patients with malignant mesothelioma was 8.8%. Resection was considered as the treatment of choice for localized mesothelioma. Thoracoscopic talc poudrage followed by chemotherapy was used for on diffuse malignant mesothelioma with pleural effusion to improve survival and prevent recurrent effusion. The histologic type, stage and treatment were identified as significant prognostic factors.