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Malignant Pleural Mesothelioma - Symptoms, Risk Factors, Diagnosis, and Treatment

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Malignant Pleural Mesothelioma - Symptoms, Risk Factors, Diagnosis, and Treatment

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Pleural mesothelioma is a tumor in the lung's mesothelium. Read the article below to learn about the symptoms, diagnosis, and treatment of pleural mesothelioma.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Kaushal Bhavsar

Published At August 1, 2022
Reviewed AtMay 17, 2024

What Is Malignant Pleural Mesothelioma?

Malignant pleural mesothelioma is a rare disease but the most common type when compared to other lung cancers. The lungs, heart, and abdomen are enclosed by a protective membrane called mesothelium. When the cancer cells invade this tissue, they end up in malignant pleural mesothelioma. The first and foremost reason for pleural mesothelioma is asbestos. This hazardous chemical affects the mesothelial cells and causes malignant tumors in the lungs.

What Are the Different Types of Malignant Pleural Mesothelioma?

  • Epithelioid Mesothelioma: The most prevalent type of malignant mesothelioma, accounting for 60 % to 80 % of cases, is epithelioid mesothelioma. Treating this type is the simplest.

  • Sarcomatoid Mesothelioma: 10 % of cases of malignant mesothelioma are sarcomatoid mesothelioma, which is the rarest type. It is more difficult to cure than epithelioid mesothelioma and grows more quickly.

  • Biphasic Mesothelioma: Between 10 and 15 percent of cases of malignant mesothelioma are uncommon. It has a mixture of sarcomatoid and epithelioid cell types.

A medical professional can assess which treatments might be most effective for the particular kind of pleural mesothelioma as well as the prognosis, or expected course of treatment.

What Are the Symptoms Associated With Malignant Pleural Mesothelioma?

There are no symptoms during the earlier stage of malignant pleural mesothelioma. The symptoms start appearing after 30 to 50 years of asbestos exposure. They are as follows;

  • Cough - The irritation in the throat due to the chemical causes discomfort and a long-lasting dry cough. In severe cases, it indicates chronic lung diseases like malignant pleural mesothelioma. A dry cough does not expel mucus.

  • Shortness of Breath - The patient is unable to inhale the air completely into the lungs. This medical condition is known as dyspnea. It lasts for more than one to two months.

  • Chest Pain - The mesothelial lining contains lubricant fluid for the lungs. The chemical ruptures the mesothelial lining and leaks the fluid into the chest space. This results in pleural effusion. The patient has chest pain due to the distribution of fluid around the lungs.

  • Loss of Appetite - The patient is unable to swallow due to the feeling of a sore throat. The patient does not feel hungry to eat.

  • Weight Loss - The patient becomes tired and loses weight unintentionally.

  • Fever - The body temperature increases with the swelling of the face and arms. The patient has unexplainable back pain.

What Are the Risk Factors for Malignant Pleural Mesothelioma?

  • Occupational Exposure: The workers in the construction sites involved in plumbing, electric work, insulation, and workers undermining are exposed to asbestos. Because this hazardous chemical is used as an insulating material (heat resistant to fire accidents), these workers are exposed for a long period due to their occupation. They are at a higher risk for malignant pleural mesothelioma.

  • Family History: It is a rare phenomenon. The gene is inherited due to mutations that cause mesothelioma.

  • Radiation Therapy: If the child is given radiation therapy for any congenital disorders, they are prone to mesothelioma in the future.

How Is the Malignant Pleural Mesothelioma Diagnosed?

The lungs are diagnosed with various tests to rule out the malignant pleural mesothelioma condition. They are as follows;

  • X-Rays - The medical professional requests an X-ray as the first diagnosis for the patient with chest pain. The progress of the disease in the lungs and ribs can be identified. Any structural changes in the chest can be detected. If the fluid is present in the pleural (lung) space, it can also be detected.

  • CT (Computed Tomography) Scan - Asbestos irritates the mesothelial tissue and causes inflammation in the pleural tissue. It results in the thickening of the pleural tissues. This condition can be detected using computed tomography. The presence of plaques in the pleural space due to the deposition of calcium is observed using this scan.

  • Biopsy - For lung tumors like malignant pleural mesothelioma, a biopsy is considered the final diagnosis. The mesothelial tissue invaded by the cancer cells is removed using a special tool and sent to the lab examination. The type of cancer is detected with the help of cancer cells. If other organs are affected, including the lungs, then the tissue is also removed from those organs for a biopsy report.

  • Positron Emission Tomography (PET) - The radioactive atoms are used to record pictures of the lungs. Since mesothelioma observes more radioactive substances, it appears darker than the normal tissue. It captures the entire lungs, pleural lining, and the chest affected by malignant pleural mesothelioma.

  • Magnetic Resonance Imaging (MRI) - It is a combination of radio waves and magnets. It is particularly useful in providing a detailed image of the soft tissues present behind an organ. Mesothelioma affects the diaphragm. It is present under the lungs. This cancerous tissue is identified with the help of magnetic resonance imaging.

What Are the Different Types of Treatment Methods for Malignant Pleural Mesothelioma?

It is the most aggressive type of cancer and requires frequent treatment. The three treatment modes include surgery, medications, and radiation therapy. The patient is given any of the two treatment combinations. They are as follows;

  • Surgery - A wide excision is made to remove the mesothelioma. A small part of the adjacent healthy tissue is also removed to prevent the spread. The surgeon removes the lining of the lungs and the chest. This surgical procedure is known as pleurectomy. If the cancer cells invade the lungs from the outer covering, then the part of the lungs is removed. This surgical procedure is called a pneumonectomy. The fluid accumulation can be controlled by a drug application. This prevents scarring and helps heal the mesothelial tissue.

  • Radiation Therapy - The growth and proliferation of the mesothelioma cells is inhibited using high-energy rays. There are two types of radiation - external radiation and internal radiation. The rays are produced outside the lungs in case of external radiation. In internal radiation, the rays are produced by the radioactive substance placed inside the body near the mesothelioma.

  • Chemotherapy - The drugs are given orally or through the vein or muscle to reach the mesothelioma. This kills the cancer cells in the malignant pleural mesothelioma.

  • Immunotherapy - Patients affected by mesothelioma have a weak immune system. The immune cells are unable to defend the cancer cells. Certain drugs like Nivolumab and Ipilimumab are prescribed as immunity boosters by medical professionals.


The progression of the malignant pleural mesothelioma is rapid. So, the patient must take serious action if the symptoms are observed. The number of people exposed to asbestos has been fewer in recent days. So, there is a decrease in pleural mesothelioma outbreaks. The prognosis of malignant pleural mesothelioma depends on the size and extent of the tumor. It also depends on other systemic diseases since it occurs after 50 years of asbestos exposure.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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