diffuse mesothelioma
Introduction
Introduction to diffuse mesothelioma Pleural mesothelioma has a prognosis of benign fibrous mesothelioma and diffuse malignant pleural mesothelioma, which is considered to be the worst prognosis of the chest. There are no effective treatments to date. All kinds of asbestos fibers are almost related to the pathogenesis of mesothelioma, but the risk of self-sufficient fibers is not the same. The most dangerous is exposure to bluestone, the least dangerous is exposure to asbestos, the first exposure to asbestos. The incubation period of the disease is generally 20 to 40 years. The incidence of mesothelioma is directly proportional to the time and severity of exposure to asbestos. If the content of zeolite in the atmosphere increases, the inhalation of this powder of silicate zeolite can also cause Skin tumor. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: lung cancer, pleural effusion
Cause
Diffuse mesothelioma
All kinds of asbestos fibers are almost related to the pathogenesis of mesothelioma, but the risk of self-sufficient fibers is not the same. The most dangerous is exposure to bluestone, the least dangerous is exposure to asbestos, the first exposure to asbestos. The incubation period of the disease is generally 20 to 40 years. The incidence of mesothelioma is directly proportional to the time and severity of exposure to asbestos. If the content of zeolite in the atmosphere increases, the inhalation of this powder of silicate zeolite can also cause There are also reports of cases of pleural mesothelioma after exposure to radiation. The time from exposure to radiation to pleural mesothelioma is 7 to 36 years, with an average of 16 years, nitrosamine, fiberglass, hydrocyanic acid, oxidation. Hemorrhoids, sputum and other lung diseases (such as tuberculosis and chemicals and lipid aspiration pneumonia) can cause pleural mesothelioma.
Prevention
Diffuse mesothelioma prevention
Asbestos workers with malignant pleural tumors have an average survival time of 11.4 months from symptom onset to death. Most patients die within 1 year. The next step should be to synthesize various treatments more scientifically and develop new technologies so that Find more effective medicines and diagnostic methods to treat them early.
Complication
Diffuse mesothelioma complications Complications, lung cancer, pleural effusion
Can be complicated by asbestosis, bronchial lung cancer, pleural plaque, pleural effusion and so on.
Symptom
Diffuse mesothelioma symptoms Common symptoms Thoracic pain, pleural pleural pleural metastasis, widened pleural pleural pleural thickening, shortness, shortness, weight loss, chest wall collapse, exudative pleural effusion
Patients with exudative pleural effusion, especially those with a history of exposure to asbestos should consider the diagnosis of malignant pleural mesothelioma. Chest CT can confirm the diagnosis. Chest CT can determine whether pleural calcification or bone structure is destroyed. When the tumor invades the diaphragm and In the chest wall, magnetic resonance imaging is better than CT, although pleural effusion smear, chest pleural biopsy and pleural effusion cell block can make a malignant diagnosis, but can not identify pleural metastatic adenocarcinoma and malignant mesothelium. In the past 10 years, three technologies have been developed, which are definitely helpful in the diagnosis of malignant mesothelioma. These three techniques are histochemical staining with periodic acid-Schiff liquid, with keratin and carcinoembryonic resistance. Original immunoperoxidase assay and electron microscopy. For these tests, biopsy specimens must be fixed immediately with neutral Formalin. Another small tumor biopsy specimen is destined for use in glutaraldehyde for electron microscopy. .
Periodate-Schiff staining (PAS) is the only reliable histochemical method for distinguishing malignant pleural mesothelioma from adenocarcinoma. Although the characteristics of various metastatic adenocarcinomas are different, they are strongly positive after amylase digestion. Vacuation can be diagnosed as adenocarcinoma rather than malignant pleural mesothelioma.
The immunoperoxidase technique uses antibodies to act on keratin and carcinoembryonic antigen (CEA). This method also effectively distinguishes malignant pleural mesothelioma from metastatic adenocarcinoma and immunoperoxidase staining for carcinoembryonic antigen. Malignant pleural mesothelioma is usually stained with little or no coloration. On the contrary, adenocarcinoma is moderately and strongly stained. In addition, studies on the immunoperoxidase on keratin have also shown that mesothelioma is significantly different from adenocarcinoma. At present, 8 markers have been found for identification: tumor with glycoprotein 72 (B72.3), Leu-Mi, Vimentin, thrombomodulin, mucin component, cancer antigen positive for 100% specificity and sensitivity of adenocarcinoma Sex, because carcinoembryonic antigen test often has false negatives, it is best to use two tumor markers, generally using CEA and B72.3, such as positive for both adenocarcinoma with 100% specificity and 88% sensitivity; Both were negative, with 100% specificity and 97% sensitivity to mesothelioma.
Examine
Diffuse mesothelioma examination
Routine laboratory examination: thrombocytopenia can be found during the onset of the disease, platelets up to 1000 × 109 / L, serum carcinoembryonic antigen is elevated in some patients, serum immunoelectrophoresis IgG, IgA or IgM is elevated, the reason is still From time to time, serum fetal protein is generally normal.
Patients with exudative pleural effusion, especially those with a history of exposure to asbestos should consider the diagnosis of malignant pleural mesothelioma. Chest CT can confirm the diagnosis. Chest CT can determine whether pleural calcification or bone structure is destroyed. When the tumor invades the diaphragm and In the chest wall, magnetic resonance imaging is better than CT, although pleural effusion smear, chest pleural biopsy and pleural effusion cell block can make a malignant diagnosis, but can not identify pleural metastatic adenocarcinoma and malignant mesothelium.
In the past 10 years, three technologies have been developed, which are definitely helpful in the diagnosis of malignant mesothelioma. These three techniques are histochemical staining with periodic acid-Schiff liquid, with keratin and carcinoembryonic resistance. Original immunoperoxidase assay and electron microscopy. For these tests, biopsy specimens must be fixed immediately with neutral Formalin. Another small tumor biopsy specimen is destined for use in glutaraldehyde for electron microscopy. .
Periodate-Schiff staining (PAS) is the only reliable histochemical method for distinguishing malignant pleural mesothelioma from adenocarcinoma. Although the characteristics of various metastatic adenocarcinomas are different, they are strongly positive after amylase digestion. Vacuation can be diagnosed as adenocarcinoma rather than malignant pleural mesothelioma.
The immunoperoxidase technique uses antibodies to act on keratin and carcinoembryonic antigen (CEA). This method also effectively distinguishes malignant pleural mesothelioma from metastatic adenocarcinoma and immunoperoxidase staining for carcinoembryonic antigen. Malignant pleural mesothelioma is usually stained with little or no coloration. On the contrary, adenocarcinoma is moderately and strongly stained. In addition, studies on the immunoperoxidase on keratin have also shown that mesothelioma is significantly different from adenocarcinoma. At present, 8 markers have been found for identification: tumor with glycoprotein 72 (B72.3), Leu-Mi, Vimentin, thrombomodulin, mucin component, cancer antigen positive for 100% specificity and sensitivity of adenocarcinoma Sex, because carcinoembryonic antigen test often has false negatives, it is best to use two tumor markers, generally using CEA and B72.3, such as positive for both adenocarcinoma with 100% specificity and 88% sensitivity; Both were negative, with 100% specificity and 97% sensitivity to mesothelioma.
Electron microscopy is also useful for the diagnosis of malignant pleural mesothelioma and pleural metastatic adenocarcinoma. Malignant pleural mesothelioma is different from lung, breast cancer and upper gastrointestinal cancer. The surface of the adenocarcinoma is fine and long. Branches, rich in tension silk, small roots and sheets containing no microvilli; metastatic adenocarcinoma derived from ovary and endometrium with intrinsic tissue deformation, including abundant mucin droplets, large cilia, dense nuclear particles These changes are not present in stromal tumors, and the villi of adenocarcinoma are short and thick.
Diagnosis
Diagnosis and diagnosis of diffuse mesothelioma
It is differentiated from pleural metastatic adenocarcinoma and diffuse tuberculosis.
