Mesothelioma

Classification according to ICD-10
C45	Mesothelioma ICD-O M9050 / 3
C45.0	Mesothelioma of the pleura
C45.1	Mesothelioma of the peritoneum
C45.2	Mesothelioma of the pericardium
C45.7	Mesothelioma of other locations
C45.9	Mesothelioma unspecified
ICD-10 online (WHO version 2019)

The mesothelioma is a diffuse growing tumor . Mostly it occurs in the pleura ( pleural mesothelioma ), the pericardium and the peritoneum as well as on the tunica vaginalis testis .

People who have had contact with asbestos ( asbestosis ) are particularly affected . As with most tumors, mesothelioma can come in two forms: benign (benign, non-invasive and slow-growing) and malignant (malignant, invasive and fast-growing).

definition

Mesotheliomas are often difficult to diagnose, relatively rare (about 3000 new cases per year in the US), connective tissue tumors of the mesothelium , especially the pleura . Men are more often affected by the disease (probability approx. 1: 1000 or 4: 1, depending on the source). According to current knowledge, mesothelioma is mostly caused by exposure to asbestos (here especially the long-fiber amphiboles ), fiberglass dust or toxicosis from cigarette smoke and other exogenous pollutants . There have also been isolated cases of Hodgkin lymphoma and other malignant cancers after radiation therapy. Forms that primarily occur in the mesothelium of the peritoneum or pericardium are much rarer. Pleural mesothelioma is a characteristic tumor form as a result of asbestosis and one of the first recognized occupational diseases, as workers in the asbestos-processing industry and construction and shipyard workers are particularly affected, which explains the increased incidence in men.

diagnosis

CT scan of a patient with mesothelioma (yellow arrows).

PET / CT of a mesothelioma

The latency period of pleural mesothelioma can be up to 40 years, so symptoms appear late and are similar to those of pleural disease. A pleural effusion can occur as a result of exudates .

The diagnosis is made through cytodiagnostic examinations from cell samples obtained by means of fine needle biopsy , histology , pleural biopsy and radiological examinations. Thoracoscopy is often pioneering . Computed tomography (CT) procedures are used to clearly diagnose metastasis of the thorax , the chest wall and the lungs. Furthermore, research groups deal with the research and establishment of biomarkers such as calretinin, mesothelin , osteopontin or fibulin . The use of such tumor biomarkers in clinical practice enables earlier and more precise diagnosis. In vitro it has even been shown that calretinin is essential for mesothelioma cells.

literature

JT Hartmann, C. Bokemeyer: Benign and malignant mesotheliomas: definition. Oncology, hematology - data and information ( Onkodin.de )
German Society for Hematology and Oncology : Malignant Mesothelioma (PDF) as of July 2005, accessed on February 28, 2016
Bruce A. Chabner, Dan L. Longo: Harrison's Manual of Oncology . 2nd edition. Chapter 50: Malignant Mesotheliomas . McGraw-Hill Education, 2014, ISBN 978-0-07-179326-1
AJ Moore et al. a .: Malignant mesothelioma. In: Orphanet Journal of Rare Diseases 3, 2008, 34. doi: 10.1186 / 1750-1172-3-34 (Review)

Web links

Commons : Mesothelioma - Collection of pictures, videos and audio files

German mesothelioma registry. Institute for Pathology at the Ruhr University Bochum
Turkey: tumor accumulation forces mass relocation . Mirror online

Individual evidence

↑ Berthold Jany, Tobias Welte: Pleural effusion in adults - causes, diagnosis and therapy. In: Deutsches Ärzteblatt , Volume 116, No. 21, (May) 2019, pp. 377–385, here: pp. 379, 381 and 384 f.
↑ V. Gotzos, P. Vogt, MR Celio: The calcium binding protein calretinin is a selective marker for malignant pleural mesotheliomas of the epithelial type . In: Pathology, Research and Practice . tape 192 , no. 2 , February 1, 1996, p. 137-147 , doi : 10.1016 / S0344-0338 (96) 80208-1 , PMID 8692714 .
↑ rme: New tumor marker of mesothelioma. In: aerzteblatt.de . October 11, 2012, accessed February 2, 2015 .
↑ Walter Blum, Beat Schwaller: Calretinin is essential for mesothelioma cell growth / survival in vitro: a potential new target for malignant mesothelioma therapy? In: International Journal of Cancer . tape 133 , no. 9 , November 1, 2013, p. 2077-2088 , doi : 10.1002 / ijc.28218 , PMID 23595591 .

[1] Berthold Jany, Tobias Welte: Pleural effusion in adults - causes, diagnosis and therapy. In: Deutsches Ärzteblatt , Volume 116, No. 21, (May) 2019, pp. 377–385, here: pp. 379, 381 and 384 f.

[2] V. Gotzos, P. Vogt, MR Celio: The calcium binding protein calretinin is a selective marker for malignant pleural mesotheliomas of the epithelial type . In: Pathology, Research and Practice . tape 192 , no. 2 , February 1, 1996, p. 137-147 , doi : 10.1016 / S0344-0338 (96) 80208-1 , PMID 8692714 .

[aerzteblatt-51996-3] rme: New tumor marker of mesothelioma. In: aerzteblatt.de . October 11, 2012, accessed February 2, 2015 .

[4] Walter Blum, Beat Schwaller: Calretinin is essential for mesothelioma cell growth / survival in vitro: a potential new target for malignant mesothelioma therapy? In: International Journal of Cancer . tape 133 , no. 9 , November 1, 2013, p. 2077-2088 , doi : 10.1002 / ijc.28218 , PMID 23595591 .