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Flashcards in Mesothelioma Deck (79)
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1

What is the median age of presentation of mesothelioma?

60 years

2

What does mesothelioma typically present after?

20-50 years after asbestos exposure

3

What is the male to female ratio of mesothelioma?

5:1

4

How is the risk of mesothelioma related to asbestos exposure?

It is estimated that the risk is linearly proportional to the intensity and duration of exposure

5

What is the risk of the risk of mesothelioma being proportional to the intensity and duration of asbestos exposure?

The latency periods between first exposure to asbestos and diagnosis of mesothelioma may vary by occupation, with shorter intervals for insulators and dock workers, and longer intervals for shipyard and maritime workers, as well as domestic exposures

6

What do a significant proportion of patients diagnosed with mesothelioma diagnosed between the ages of 20 and 40 report?

Household or neighbourhood exposure during childhood

7

Do children who present with mesothelioma have a history of asbestos exposure?

They generally have no apparent asbestos exposure

8

How long is it estimated that the incidence of mesothelioma will rise for?

Until 2020

9

Why is the incidence of mesothelioma expected to fall after 2020?

Due to increasing awareness of the role of asbestos, and measures to reduce asbestos exposure

10

How common is malignant mesothelioma?

Rare, <1% of cancers

11

Is malignant mesothelioma aggressive?

Yes, highly aggressive

12

Where does malignant mesothelioma arise from?

Primarily from the surface serosal cells of the pleural, peritoneal, and pericardial cavities

13

What is the primary cause of malignant mesothelioma?

Exposure to asbestos fibres

14

What % of patients with malignant mesothelioma have no history of exposure to asbestos fibres?

50%

15

How does the risk of malignant mesothelioma vary depending on which kind of asbestos fibre the patient is exposed to?

It is highest with blue fibres (crocidolite), then brown (amosite), and least with white (chrysolite)

16

What virus is a possible co-factor for malignant mesothelioma?

SV40

17

Why is it thought that SV40 is a possible co-factor for malignant mesothelioma?

In 60-83% of human malignant mesotheliomas, the cells express SV40 DNA

18

How does exposure to asbestos fibres cause malignant mesothelioma?

The exposure can produce reactive oxygen species when hydrogen peroxide and superoxide react to form hydroxyl radicals, which can induce DNA damage

19

What % of patients with malignant mesothelioma present with intrathoracic symptoms?

90%

20

What are the intrathoracic symptoms of malignant mesothelioma?

-Cough
-Dyspnoea
-Non-pleuritic chest wall pain

21

What symptoms can involvement of the mediastinal pleura in malignant mesothelioma cause?

-Arrhythmias
-Dysphagia

22

How common are symptoms due to the involvement of the mediastinal pleura in malignant mesothelioma?

Rare

23

What systemic symptoms are common in mesothelioma?

-Pyrexia of unknown origin
-Sweats
-Anorexia
-Weight loss

24

What are the less common symptoms of malignant mesothelioma?

-Thrombocytosis
-Disseminated intravascular coagulation
-Thrombophlebitis
-Haemolytic anaemia

25

What examination features do most patients with malignant mesothelioma present with?

-Dullness at one lung base
-Unilateral pleural effusion on CXR

26

Can malignant mesothelioma present incidentally?

Yes, occasionally patients can present asymptomatically with effusion as an incidental finding

27

What % of patients with malignant mesothelioma have bilateral involvement at the time of diagnosis?

Less than 5%

28

What % of patients with malignant mesothelioma have right sided lesions?

60%

29

What is the predominant method by which malignant mesothelioma spreads?

Local invasion of the lung, extending into the fissures and interlobular septa, adjacent organs in the mediastinum and chest wall, and may track along chest drainage sites

30

What % of patients have thoracic lymph node invasion in malignant mesothelioma?

Up to 70%