Peritoneal mesothelioma can occur in from 2 to 92 years, the average diagnosis of foreign literature age of 54 years, of which about 63% of cases in the 45 to 64 years old, the sick children, a rare tumor of mesothelial cells was no early obvious symptoms, and only to a certain size and growth of tumor involving the stomach, intestines and other abdominal organs before clinical symptoms, mainly abdominal pain, abdominal distension, ascites, abdominal mass, gastrointestinal symptoms, and systemic change.
1. Peritoneal mesothelioma, abdominal pain, abdominal pain is the most common symptoms in persistent pain, tenderness, but also for cramps or sudden paroxysmal pain, pain is usually located on the abdomen and right upper quadrant, but also abdominal pain in the next the abdomen caused by clinically misdiagnosed as ectopic pregnancy or pelvic tumors reported the occurrence of abdominal pain and violations of parietal peritoneum, cancer and gastrointestinal tract obstruction caused by adhesions and pelvic organs, organ torsion and massive ascites, abdominal mass produce placeholder effect of other factors, the nature and location of the course of abdominal pain can be changed.
2. Bloating as ascites, intra-abdominal mass and secondary dyspepsia, intestinal obstruction and other factors, patients can have varying degrees of abdominal distention, severe symptoms can affect eating, even breathing difficulties.
3. Ascites about 90% of patients with peritoneal mesothelioma absence of ascites, and the rapid growth of a considerable number of patients with ascites, ascites can be as thick yellow drainage or bloody fluid, the tumor cells with active secretion of hyaluronic acid function.
4. Peritoneal mesothelioma, abdominal mass is a common clinical manifestations, some patients while the doctor because of abdominal mass, and peritoneal mesothelioma, abdominal mass can be single, but also for multiple, texture, or more rigid hard, nodular surface, located in the greater omentum, mesenteric serosal surface of the mass can move in the physical examination, abdominal mass may have tenderness in the pelvic mass could triple by digital rectal examination or consultation found that the merger a large number of drainage of ascites in patients with ascites after abdominal mass more clearly understand the situation, detailed physical examination for abdominal mass in a preliminary understanding of the abdominal wall, substantial organ, the first visit to the clinic to provide information.
5. Other minority patients may also have loss of appetite, nausea, vomiting, diarrhea or constipation, urinary tract irritation, menstrual changes and fatigue, fever, weight loss, anemia, individual patients have low blood sugar, diffuse abdominal ossification and other clinical manifestations, When combined with other parts of the patient or peritoneal mesothelioma, mesothelioma metastasis to other organs or complications, the clinical manifestations may appear appropriate.
Very few reported patients with pleural mesothelioma, peritoneal, or exist in other parts of mesothelioma, peritoneal mesothelioma, mesothelioma and other parts or for multicentric occurrence or metastases of primary tumor and the relationship, it is not too clear.
A large number of autopsy material showed that the peritoneal mesothelioma can only dip and abdominal pelvic organs, can also cause distant metastasis, direct invasion of peritoneal mesothelioma and gastrointestinal tract, some patients can be tumor cells directly to a depth of mucosal invasion lower, or even mucous layer, peritoneal mesothelioma can also invade to the abdominal wall, liver, gallbladder, pancreas and bladder, prostate and other organs, tumor metastasis to the lymph nodes and can also be the liver, lungs, heart, kidney, adrenal gland, bone marrow and other tissues and organs .
Squeeze the gastrointestinal tract tumor, adhesion and invasion of gastrointestinal and gastrointestinal wall, peritoneal mesothelioma can cause intestinal obstruction.
The onset of occult peritoneal mesothelioma, clinical manifestations do not have specific, positive rate of the supplementary examination is not high, specificity is not strong, so its very difficult clinical diagnosis, early cases reported in the literature or even more by the laparotomy for other diseases surgery (eg hernia repair) when the biopsy was confirmed, with laparoscopy, B ultrasound and CT guided biopsy technology, carry out and pathology, immunohistochemistry and electron microscopic diagnosis level, more and more cases and even in his lifetime clearly preoperative pathological diagnosis.
Clinically unexplained abdominal pain, abdominal distension, ascites and abdominal mass in patients, especially when the patient with asbestos exposure history, should consider the diagnosis of peritoneal mesothelioma and peritoneal cytology examination and repeated the inspection, such as abdominal CT examination revealed the typical changes, the examination and failed to find other parts of the evidence of a primary tumor, should be highly suspected diagnosis of peritoneal mesothelioma may be related to pathology by laparoscopy and diagnosed, if necessary, consider laparotomy diagnosis and surgical treatment for the same time.
Exfoliated cells in the ascites and biopsy less ordinary light microscope staining sometimes difficult pathological diagnosis, immunohistochemistry, electron microscopy can help confirm the diagnosis.
Made in the diagnosis of peritoneal mesothelioma at the same time, should understand their stage of disease, disease of the morning and evening on the choice of treatment, the prognosis significance of the decision, made in 1976, Butchart and other changes to the mesothelioma program divided into 4 stages period, Ⅰ period: tumor confined to ipsilateral pleura, lung, pericardium, or peritoneum; Ⅱ of: tumor invading the chest wall, mediastinum, and (or) chest or abdominal lymph nodes within the corresponding structure; Ⅲ of: penetrating the diaphragm, chest , extraperitoneal lymph node involvement; Ⅳ period: distant metastasis, and some scholars have differences of opinion still exist in the program, it needs to be further improved.
