Clinical Analysis And Review Of The Literature Of 11 Cases With Malignant Pleuralmesothelioma

[Objective:] To investigate the clinical features, diagnosis, treatment and prognosis of malignant pleural mesothelioma. So as to rednce misdiagnosis and missed diagnosis and to improve the awareness level of clinicians.[Methods] The clinical data of 11 cases of MPM ,which were treated from January 1991 to June 2008 in the affiliated hospital of Zun yi medical college,was analyzed retrospectively and the literature was reviewed and discussed..[Results] Of all the 11 cases ,7 cases were male ,4 cases were female. Male female = 1.75 : 1, The average age of the patients was 51.5 years old. 7 cases had chest pain in their first clinical symptom, 6 cases had cough, 5 patients had dyspnea after physical labor and 2 patients had clinically characteristic with shoulder pain, 1 case had a fever..We could find 9 cases showing plenty of pleural effusion on chest X-ray, 6 cases had shown irregular pleural thickening and 5 cases displayed multi - nodule wavelike shadow on the chest CT, 4 cases had lung metastasis and 1 case had mediastinal lymph node metastasis and 1 case had displayed distant metastasis,.Of all the diagnosed cases, 1 case was diagnosed with via the needle biopsy of pleura .,1 case was diagnosed by finding malignant pleural mesothelioma cell on cytologic examination in effusion of 7 cases were examined. 7 cases had shown exudate on thoracentesis ,9 cases were diagnosed with thoracoscopic pleural biopsy and immunohistochemistry ,1 cases was diagnosed with percutaneous pleural biopsy and immunohistochemistry 1 case was diagnosed with finding confirmed malignant pleural mesothelioma cells by pleural effusion cytology examination and immunohistochemistry 8 cases were displayed with epithelioid mesothelioma by biopsy: 5 cases had shown tubular nipple variant,3 cases had shown variant adenomatoid; 1 case displayed sarcomatoid mesothelioma; 1 case desmoplastic mesothelioma, 1 case found mesothelial cells in the pleural but could not classified .8 cases were treated with surgery, radiotherapy, chemotherapy and other treatment.5 years survival percentage is 0.[Conclusion:] Chest pain,shortness of breath and cough are the main performance in malignant pleural mesothelioma cases.The main characteristics of the chest CT are the pleural membrane anomalous accumulation, the pleural membrane tubercle shade, the chest cavity accumulates the fluid , the lung shift and the mediastinum lymph node shift. Chest CT performance is the important diagnosis basis..Needle biopsy of pleura and cytologic examination of effusion are the most important diagnosismeasure. MPM is treated with surgery, radiotherapy, chemotherapy and complex therapy method .These effects are unsatisfied.Malignant degree of MPM is high and the prognosis is bad.