pericardial mesothelioma
Introduction
Introduction to pericardial mesothelioma Mesothelioma of pericardium is a primary pericardial malignancy, which is different from mesothelioma that occurs in the atrioventricular node, which is benign. Tumors originate from the intracardiac lymphocytic endoderm and mesoderm mesothelial cells. Most of the cells show diffuse growth, involving the parietal and visceral layers of the pericardium, which thickens the pericardium and often spreads to include the superficial myocardium. Adjacent tissue can be transferred to local lymph nodes, but distant metastasis of abdominal organs and bone marrow is rare. A few tumors have localized growth. Pericardial mesothelioma lacks clear histological features, is difficult to classify, and is mostly histologically exclusive. diagnosis. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: myocardial infarction, heart failure
Cause
Pericardial mesothelioma
(1) Causes of the disease
Some scholars believe that the occurrence of the disease is related to exposure to asbestos and fiberglass, and it belongs to the asbestosis and is identified as an occupational disease, but this causal relationship does not exist in all cases.
(two) pathogenesis
Tumors originate from intracardiac lymphocytes, endoderm and mesoderm mesothelial cells, most of which exhibit diffuse growth, involving the parietal and visceral layers of the pericardium, allowing the pericardium to be extensively thickened and often spread to include shallow myocardium. Adjacent tissues within the body can be transferred to local lymph nodes, but distant metastasis of abdominal organs and bone marrow, a small number of tumors have localized growth, pericardial mesothelioma lacks clear histological features, difficult to classify, and histologically Exclusive diagnosis.
Prevention
Pericardial mesothelioma prevention
1. Prevention of tumors is different from the prevention of common infectious diseases. Because its etiology and pathogenesis are complex, its meaning is far from being able to include only the elimination of pathogenic factors. Therefore, the concept of cancer prevention highlights the cause of elimination, that is, the prevalence of cancer. On the basis of etiology, reduce or eliminate pathogenic factors, treat precancerous conditions, and fully use comprehensive treatment to improve the treatment level of tumors, reduce the mortality rate, and maximize the effective control of tumors.
2, early detection, early diagnosis and early treatment of the comprehensive measures of this disease, such as lesions, the preferred surgical resection, but can be completely removed, the lesions diffuse pericardial opening decompression or pericardial resection can alleviate clinical symptoms, but the prognosis is poor.
Complication
Pericardial mesothelioma complications Complications, myocardial infarction, heart failure
Complications such as pericardial tamponade, myocardial infarction, and heart failure may occur.
Symptom
Symptoms of pericardial mesothelioma Common symptoms Difficulty breathing, sitting breathing, Qimai pericarditis, chest pain, pericardial filling, jugular vein anger, pericardial effusion, weight reduction, myocardial infarction
All ages can suffer from this disease, but more common in 30 to 50 years old, the ratio of male to female incidence is 2:1, clinical manifestations similar to acute pericarditis, such as post-sternal pain, difficulty breathing, sitting breathing, etc. It indicates that there is pericardial tamponade and narrowing. When the tumor invades into the coronary artery, it can cause myocardial infarction or acute pericardial tamponade. In addition to local symptoms, it can have systemic manifestations such as fever, discomfort, weight loss, and sometimes the pericardial friction sound. There may also be odd veins, jugular vein engorgement, hepatomegaly, lower extremity edema and other pericardial tamponade signs. The pericardial fluid may be serous in the early stage and mostly bloody.
Examine
Pericardial mesothelioma
1, tumor cells can be found in the pericardial puncture fluid, which is helpful for the diagnosis of the disease.
2, chest X-ray: visible heart shadow increased, the boundaries of each arc is unclear, the shape changes, see the local irregular protrusion or nodules.
Diagnosis
Diagnosis and diagnosis of pericardial mesothelioma
Diagnostic criteria
1, pericardial mesothelioma due to non-specific clinical manifestations, the diagnosis is quite difficult. The following conditions suggest that pericardial mesothelioma may:
(1) Unexplained heart failure, especially in the case of right heart congestive heart failure.
(2) Chest pain, fatigue, and cachexia that are difficult to explain.
(3) Repeatedly a large number of pericardial effusions, especially bloody pericardial effusion.
(4) X-ray examination showed an increase in heart shadow, abnormal shape, such as local irregular protrusion or nodules.
2. Diagnostic criteria for primary pericardial mesothelioma as defined by Anderson et al. (1974)
(1) The tumor must be located on the pericardium.
(2) Transfer only to the lymph nodes.
(3) There are no other primary tumor lesions.
Pericardial fluid to find tumor cells, pericardial biopsy, X-ray examination, echocardiography, magnetic resonance and CT examination are helpful for diagnosis.
Differential diagnosis
Pericardial mesothelioma mainly needs to be differentiated from primary benign mesothelioma, pericarditis and pericardial metastases.
Primary benign mesothelioma (atrioventricular nodal tumor): occurs in the pericardial nest of the embryonic residual mesothelial stagnation adjacent to the atrioventricular node, which may affect the junction of the cardiac conduction system. Normal function, it is considered to be the smallest tumor that can cause sudden death in patients. It is more common in adult women. Its biological behavior is different from that of mesothelioma from the pericardium. Surgical resection of this disease can easily lead to cardiac block, the most appropriate treatment. It is an atrioventricular pacemaker.
