In recent decades, the incidence of mesothelioma is increasing year by year, the autopsy report of the incidence rate of 0.2%, and in the incidence of asbestos workers in up to 5% to 7%, mesothelioma, pleural mesothelioma is the most in order to , over the age of 40, 5% of pleural mesothelioma, mesothelioma, more men than women, epidemiological investigation proved closely related mesothelioma and asbestos exposure history.
1 Subjects and Methods
The clinical data of 1.1 asbestos products factory carding a workshop Lee, M, 46 years old, worked for 25 years, I recently fell ill, as to check my unit.
1.2 Clinical manifestations
1.2.1 history taking no past medical history; carding workshop on asbestos products factory for 25 years, occasional smoking, not drinking.
1.2.2 Clinical symptoms of chest pain, chest tightness, shortness of breath, cough, sputum, weight loss and other symptoms.
1.2.3 examination T37.5; P96 times / min; R24 times / min; BPl6/11KPa.
1.2.4 auscultation, decreased breath sounds on the right.
1.3 Pulmonary Function limited ventilation dysfunction, diffuse functions decreases.
2 imaging
2.1 X-ray performance
2.1.1 a small amount of pleural effusion, pleural thickening limitations, costophrenic angle disappeared.
2.1.2 the performance of several months follow-up chest x large pleural effusion, large areas of irregular pleural thickening, pleural plaque calcification without mediastinal shift, widened intercostal space, no vertebral or rib destruction.
2.2 CT image changes can be seen extensive nodular pleural thickening, a large pleural effusion, lymph nodes.
2.3 MRI changes T1W1 large flake on the irregular, slightly higher signal; T2W1 on the elongated T2 high signal. Bloody pleural effusion was a long short T1 T2 signal.
3, diffuse pleural biopsy confirmed pleural mesothelioma.
4 Discussion
4.1 Differential diagnosis
4.1.1 pleural metastatic tumors from other parts of the primary tumor metastasis to the pleura and the formation, such as a bilateral nodules of different sizes, and those separated from each other may be metastases, while the front row of the kinds of large nodular lesions may be diffuse pleural mesothelioma.
4.1.2 empyema associated with diffuse pleural thickening usually associated with narrow intercostal space, thickening of the pleura are relatively straight medial margin, and diffuse thickening of the pleura mesothelioma often wavy inner edge processes, intercostal space and not narrow, often inversely proportional to the healthy side is wide.
4.2 The disease is caused by the working environment in asbestos products diffuse pleural mesothelioma, cancer is occupational category. According to my 25-year history of exposure to asbestos dust, clinical manifestations, imaging changes and pleural biopsy diagnosis was established.
