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From the archives of the AFIP. Malignant pleural mesothelioma: radiologic-pathologic correlation
B H Miller1, M L Rosado-de-Christenson, A C Mason
1Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Abstract:
Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm that typically affects individuals occupationally exposed to asbestos through a variety of industries. The patients experience an insidious onset of symptoms, including dyspnea, chest pain, cough, malaise, and weight loss. The pathologic diagnosis of MPM is difficult, and special stains or immunohistochemical or ultrastructural analysis may be required to differentiate MPM from metastatic adenocarcinoma. The tumor affects both the parietal and visceral pleural surfaces and progresses to encase the lung and invade the lung, mediastinum, and chest wall. Radiologically, MPM manifests as unilateral pleural effusion, pleural nodules, or pleural masses. Imaging studies are useful for diagnosis and staging in patients who are potential surgical candidates. Although a variety of multimodality therapies are available and radical surgical procedures have been developed, the prognosis remains dismal.
Insights
Malignant pleural mesothelioma (MPM) is a rare cancer linked to asbestos exposure. Diagnosis is challenging, and despite treatment options, the prognosis for MPM remains poor.
Area of Science:
- Oncology
- Pathology
- Radiology
Background:
- Malignant pleural mesothelioma (MPM) is a rare cancer primarily caused by occupational asbestos exposure.
- Symptoms include shortness of breath, chest pain, cough, and weight loss, often with insidious onset.
- Distinguishing MPM from metastatic adenocarcinoma requires specialized diagnostic techniques.
Purpose of the Study:
- To summarize the key aspects of malignant pleural mesothelioma.
- To highlight diagnostic challenges and imaging findings.
- To provide an overview of treatment modalities and prognosis.
Main Methods:
- Review of clinical presentation and pathological diagnostic criteria for MPM.
- Analysis of radiological manifestations including pleural effusion, nodules, and masses.
- Discussion of current multimodality treatment strategies and surgical options.
Main Results:
- MPM presents with diverse symptoms and affects pleural surfaces, encasing the lung.
- Radiological imaging is crucial for diagnosis and staging in surgical candidates.
- Despite available therapies, the overall prognosis for MPM is dismal.
Conclusions:
- MPM is a challenging diagnosis requiring specialized methods.
- Early detection through imaging aids staging for potential surgical intervention.
- Current treatments offer limited improvement in the poor prognosis of malignant pleural mesothelioma.