ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. D19C45ArtikelübersichtMesotheliom
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Mesothelioma is an overgrowth (tumor) of the mesothelium. This is a single-layered epithelial tissue that forms the boundary of body cavities such as pleura, pericardium and peritoneum. It usually lays as a planar tumor around the lungs.
Like most tumors, mesothelioma can appear in benign and malignant forms. The latter is often the result of asbestos exposure. The latency is long: about 35 years elapse between exposure to asbestos and the onset of the first symptoms. If you have been professionally exposed to asbestos and suffer from a malignant mesothelioma, this is considered a recognized occupational disease.
Malignant mesotheliomas are more than 80 percent pleural mesothelioma, ie tumors that emanate from the pleura (pleura: pleura and lung fur). This is referred to as breast cancer or pleural cancer.
About 20 people per million inhabitants in Germany suffer from mesothelioma every year. In many industrialized countries, asbestos was banned, yet the incidence seems to be increasing. Men become three to five times more likely to have mesothelioma than women. The higher the age, the higher the disease risk.To the table of contents
The pleural cancer symptoms can be very different. It can take up to half a year between the first symptoms and the final diagnosis.
Most sufferers of mesothelioma of the pleura report shortness of breath as the first symptom. In addition, pain in the area of the chest can occur when the intermediate ribs nerves are irritated or the chest wall is infiltrated.
In rare cases, a high diaphragm or a cough may occur. Also rare in pleuropod cancer so-called paraneoplastic symptoms such as anemia, weight loss, fever or a spontaneous pneumothorax (sudden ingress of air into the slit-shaped space between the lung and pleura).
Unilateral pleural effusions or pulmonary thickening with concomitant chest pain may be further evidence of mesothelioma.To the table of contents
Mesothelioma: causes and risk factors
Up to 90 percent of pleural mesothelioma cases can be attributed to asbestos exposure. There has been an asbestos ban in Germany since 1993. Asbestos has been banned in the EU since 2005. Nevertheless, asbestos continues to be massively used industrially worldwide, for example as an insulating material in the construction industry. So far, no limit has been established under which there is no risk of mesothelioma.
About ten to twenty percent of mesothelioma disorders are not caused by asbestos, but for example by zeolite (erionite), an asbestos-like fiber. In addition, other factors are suspected of being able to trigger a mesothelioma. These include, for example, the so-called SV-40 viruses, repeated inflammations and a genetic predisposition to mesothelioma. In addition, experts are currently investigating whether nanomaterials such as nanotubes can also lead to malignant mesothelioma.To the table of contents
Mesothelioma: examinations and diagnosis
If you have signs of pleural mesothelioma, you should consult a GP or pulmonologist. To diagnose a mesothelioma, the doctor will ask exactly the symptoms and your medical history. Typical questions of the doctor would be for example:
- Since when and how often do you have complaints, such as coughing?
- Are you getting bad air?
- Do you have tough expectoration when coughing?
- Has fever also occurred? Do you sweat hard at night?
- Do you have contact with asbestos professionally or privately?
- Do you live or work in the vicinity of astbest processing factories?
- Have you been to areas with natural asbestos deposits?
- Do you live in an old building with asbestos-containing components?
If a mesothelioma is suspected, referral to an experienced lung center is useful. To confirm the suspected diagnosis, further physical examinations follow. To record the size of the tumor, imaging techniques such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) can be performed. Final certainty in suspected mesothelioma brings a histological examination of the altered tissue.
To determine whether water has accumulated between the lung and pleura (pleural effusion), the chest is examined by ultrasound (transthoracic ultrasound). A pleural function (see below) is also performed under ultrasound control.
Computerized tomography (CT) is the best way to detect and detect mesothelioma. In addition, it can be determined by means of CT whether the tumor has already formed secondary tumors (metastases) in the lymph nodes.
If it is suspected that the tumor has spread to the diaphragm or chest wall, magnetic resonance imaging (MRI) can be performed. Also, a so-called positron emission tomography (PET) is useful, especially to detect distant metastases.