Pleural mesothelioma is a dangerous cancer that affects the lining of the lungs (the pleura). Its symptoms include chest pain, coughing, and shortness of breath. Patients with malignant pleural mesothelioma have an average life expectancy of 1-2 years.
What Is Pleural Mesothelioma?
Pleural mesothelioma is a rare type of cancer caused by asbestos exposure. Mesothelioma tumors develop in the pleura, the thin membrane that lines the chest cavity and lungs.
Malignant pleural mesothelioma is the most common type of mesothelioma, making up roughly 80% of all diagnosed cases.
Pleural Mesothelioma Symptoms
Mesothelioma has a latency period of 20-50 years, meaning its development takes a long time. Its symptoms may not appear until decades after a patient is first exposed to asbestos.
Despite the long latency period, the average time from when symptoms appear to diagnosis is 2-3 months.
Common symptoms of pleural mesothelioma include:
- Chest pain
- Chronic shortness of breath
- Lumps noticed on the skin of the chest wall
- Persistent cough
- Unexplained weight loss
- Rib pain
- Shoulder pain
- Upper back pain
Since mesothelioma is not a common form of cancer, many doctors have limited experience with it. Doctors may mistake pleural mesothelioma for more common conditions like lung cancer, pneumonia, bronchitis, or chronic obstructive pulmonary disorder (COPD).
If you have been exposed to asbestos — especially if you are displaying any of the above symptoms of mesothelioma — contact your doctor as soon as possible.
Diagnosing Pleural Mesothelioma
If your doctor suspects mesothelioma after a physical examination, they will often prescribe a series of imaging tests to look for any visual indications of this cancer.
Imaging tests for pleural mesothelioma include:
- Chest X-ray
- CT scan
- PET scan
- MRI scan
- PET-CT scan
During these scans, doctors will look for specific signs that may represent potential mesothelioma.
Signs that may indicate malignant pleural mesothelioma include:
- Calcium Deposits: Calcium deposits on the pleura are the first sign that asbestos has entered the pleural membrane.
- Pleural Plaques: Asbestos causes noncancerous buildups of collagen (called pleural plaques) on the pleural membrane.
- Pleural Effusions: Inflammation of the pleural membrane can result in fluid build-up (pleural effusions) in the chest cavity. Pleural effusions occur in over 90% of patients with this form of mesothelioma.
If your doctor detects any abnormalities during imaging tests or other biomarker blood work, they may conduct a biopsy.
Pleural Mesothelioma Biopsy
A biopsy is the collection and examination of tissue (surgical biopsy) or fluid (liquid biopsy) used to test for cancer. Doctors inspect the biopsied sample under a microscope to see if any cancer cells are present.
A biopsy is the only way to confirm a pleural mesothelioma diagnosis.
Pleural Mesothelioma Surgical Biopsy vs Liquid
Many mesothelioma specialists prefer surgical biopsies (collection of tissue) over liquid biopsies (collection of fluid). In most cases, diagnosing pleural mesothelioma using a tissue sample provides less potential for misdiagnosis.
That is not to say that pleural mesothelioma cannot be diagnosed using a liquid biopsy, however.
“Guidelines from several international cytologist bodies have all confirmed that pleural fluid cytology is adequate in diagnosing the majority of cases with epithelioid mesothelioma cells.”
– Y C Gary Lee, Professor of Respiratory Medicine
Many clinicians are inexperienced with mesothelioma cytology (the study of human cells). For this reason, an accurate diagnosis using fluid cells requires the expertise of a pathologist.