MALIGNANT MESOTHELIOMA

• At least two thirds are related to asbestos exposure
• Chronic asbestos exposure carries a 2-3% risk of mesothelioma; risk is not increased by smoking (note: risk of adenocarcinoma much higher); amphiboles (esp. crocidolite) are most carcinogenic; chrysotile is least carcinogenic
• Long latency between exposure and tumor: 25-45 yr Asbestos bodies more commonly found in lung
• Multiple gray or white, ill-defined nodules, diffusely thickening pleura; may grow extensively to fill pleural space and encase lung
• Most common Sx: chest pain, dyspnea, and pleural effusions (effusion almost always present)
• Prognosis uniformly bad: 50% 1 yr survival (few survive longer than 2 yr)