Mesothelioma Cancer -
Mesothelioma Diseases, Asbestos Fibers
Mesothelioma Cancer Diagnosis
Diagnosis of Mesothelioma
Our articles will give you a better understanding of the treatments available for anyone suffering from Mesothelioma.
Mesothelioma is a rare form of cancer. It affects the linings of the cavities around the lungs, stomach, and heart. It is caused by inhaling asbestos fibers, but the cancer usually does not appear until 10 to 40 years after a person first inhales asbestos.
The latest information about Mesothelioma diseases, their diagnoses, causes, treatments and the medical research currently underway to prevent and someday cure Mesothelioma. We want to help those potentially exposed to Mesothelioma to understand which materials contain Mesothelioma causing cancers and how exposures occur.
Industrial Health 2001, 39, 189-193
Case Report
A Patient with Asbestos-Induced Lung Cancer Complicated by Silicosis
Takumi KISHIMOTO* and Kaho TSUDA Department of Internal Medicine, Okayama Rousai Hospital, 1-10-25 Chikkomidorimachi Okayama, 702-8055, Japan Received December 4, 2000 and accepted February 26, 2001
Abstract: A 76-year-old male died of lung cancer. At first, he was diagnosed as a silicosis, because he had worked for 30 years as a caster in shipyard and large opacities detected by chest x-ray and CT scanning. After the operation of lung cancer, numerous asbestos bodies were observed in the operated lung tissues. The detailed occupational inquiry revealed his asbestos use as a caster in shipyard. Early stage of asbestosis was suspected by chest CT scanning, but not definitely diagnosed in premortal examinations. Asbestosis, pleural plaques, silicosis and large cell carcinoma of the lung were histopathologically confirmed at the autopsy. A patient with asbestos-induced lung cancer complicated by silicosis was rarely published in the literature.
Introduction
Among the cases of pneumoconiosis in Japan, the incidence of silicosis is prevalent high mainly in mines and coal miners. On the other hand, cases of asbestosis have been reported in only limited working places such as asbestos textile factories and shipyards. There have been few case reports of silicosis complicated by pulmonary asbestosis. We present a case of shipyard caster with large opacities due to silicosis in whom pulmonary asbestosis was histologically demonstrated by the presence of pleural plaques due to asbestos. This patient is reported with a review of the literature.
Case Report
The patient was a 76-year-old male with cough and sputum. Smoking history was 20 cigarettes per day for 45 years. He had worked as a caster in a shipyard for 30 years since 1955. Casters in shipyards often produce long tubes. To reduce distortion, he had placed asbestos on sand molds, using asbestos together with silica sand.
He developed cough and sputum in July, 1999 and received symptomatic therapy in a local hospital. However, the symptoms did not improve, and he was referred to our department and admitted. On admission, fine crackles were heard in the bilateral posterior lower lung fields, and clubbed fingers were observed. Chest X-ray films showed a large shadow probably due to silicosis in the right upper lung field and a tumor-like shadow in the left hilum (Fig. 1). CT scanning of the chest revealed large shadows in both the right upper and left upper lung fields (Fig. 2). The tumor in the left hilum observed on chest X-ray films was present in the left S6 (Fig. 3) in contact with the pleura.
The left hilar lymph nodes were swollen. These images suggested primary lung cancer. In the bilateral lower lung fields, subpleural curvilinear shadows which suggest the early stage of asbestosis (Fig. 4) were observed. Blood examination showed increased CEA (5.8 ng/ml) as a tumor marker but no other abnormalities. Blood gas analysis revealed almost normal values (PaO2, 88.0 mmHg; PaCO2, 41.6 mmHg). Lung function tests showed a %VC of 92% and an FEV1.0% of 67.8%, suggesting slight obstructive impairment. To make a definite diagnosis for the tumor in the left S6, transbronchial lung biopsy was performed. This tumor was diagnosed as non-small cell lung carcinoma. Though the stage was IIIa (T2, N2, M0), resection of the left lower lung was performed due to strong desire of his family and the absence of marked pulmonary dysfunction. However, the tumor had already extrapleurally disseminated, and metastasis to the mediastinal lymph nodes was definite, the surgery was limited to nonabsolute resection. Histological examination of surgical specimens of the lung cancer tissue showed large cell carcinoma. Numerous asbestos bodies were confirmed in both the normal lung tissue and lung cancer tissue (Fig. 5a, b). He developed acute pneumonia (MRSA pneumonia) 2 months after surgery and died of respiratory failure.
Autopsy revealed marked progression of lung cancer and metastasis to organs in the entire body including the opposite lung. The large shadows in the bilateral upper lung fields on CT images were histologically confirmed to be due to silicosis. Around these shadows, many silicotic nodules were observed (Fig. 6). Furthermore, numerous asbestos bodies were observed around silicotic nodules (Fig. 7). In areas showing fibrous changes in the bilateral lower lung fields, findings consistent with pulmonary asbestosis were obtained (Fig. 8), and pleural plaques could be also macroscopically confirmed. When lung tissue (dry weight, 1 g) was dissolved in sodium hypochlorite and filtered using a Millipore filter according to Matsuda's method1), 28,000 asbestos bodies were observed. Pathological diagnosis was asbestos-induced primary lung cancer complicated by silicosis.
Mesothelioma Symptoms
The symptoms of mesothelioma vary from type to type. Pleural mesothelioma symptoms are similar to those of viral pneumonia and can include coughing and fever. Peritoneal mesothelioma symptoms can include nausea and abdominal mass. Pericardial mesothelioma symptoms typically manifest themselves as dyspnea (shortness of breath).