Diffuse mesothelioma check what should be done?

Conventional laboratory tests: in the course of the disease can be found thrombocythemia individual platelet reported as high as 1000 × 109 / L, serum CEA in some patients with elevated serum immunoelectrophoresis IgGIgA phenomenon IgM or higher, why not, Normal serum fetoprotein



Pleural effusion are particularly exposed to asbestos in the history of the patient should consider the quality of malignant pleural mesothelioma diagnosis. Chest CT can be diagnosed, the chest CT examination can determine the structure of bone or calcified pleural any damage when the diaphragm and chest wall tumor, the magnetic resonance imaging better than CT (Figure 1). Although pleural effusion cells smear wear chest and pleural effusion cell block biopsy sections can make the diagnosis of malignant, but it can not identify metastatic cancer and malignant pleural mesothelial Liu.
Figure 1 Magnetic resonance: the lower right chest wall malignant pleural mesothelioma



Lower left lung under paragraph dorsal visceral has malignant pleural mesothelioma (surgery confirmed)



In the past 10 years has developed a 3 technology is relatively sure that this will help make a diagnosis of malignant mesothelioma. 3 This technique is based on periodic acid - Schiff staining liquid to do in order to keratinocytes and CEA for peroxidase immune electron microscope examination and inspection for the purpose of these inspections, the biopsy specimens must be used immediately in sexual music Marin liquid fixed, another small tumor biopsy specimens in the doomed glutaraldehyde solution for the use of electron microscopy



Periodic acid - Schiff stain (PAS) is the only reliable method of chemical organizations can identify malignant pleural mesothelioma and adenocarcinoma, although a variety of metastatic adenocarcinoma of the characteristics are different, but the starch in the digestive enzyme after the strong positive air Bubbles can be diagnosed with malignant pleural mesothelioma and not adenocarcinoma.



Immune peroxidase antibody technology is the use of the role of keratinocytes in protein and CEA (CEA) is also an effective method to distinguish between malignant pleural mesothelioma in metastatic adenocarcinoma. On the CEA for immune peroxidase stain and the stain of malignant pleural mesothelioma generally not very light coloring on the contrary, adenocarcinoma of the middle and strong staining. In addition to immune peroxidase on the keratinocytes study also showed that cancer and mesothelioma have significant differences. 8 have been found signs can be used to identify: tumor glycoprotein 72 (B72.3), Leu-Mi, Vimentin-modulating thrombosis, the sticky protein component, the cancer antigen positive for adenocarcinoma 100% sensitivity and specificity As the CEA often false-negative test, it is the best choice of two tumor markers, in general, such as the use of CEA and B72.3 both positive for adenocarcinoma of the specificity of 100% and 88% sensitivity; if both Negative, mesothelioma 100% and specificity of 97% sensitivity.



Electron microscope examination of the identification of malignant pleural mesothelioma and metastatic adenocarcinoma also use malignant pleural mesothelioma from lung, breast and upper gastrointestinal cancer is the source of its surface microvilli long and thin, and there are branches Wire tension than the rich, no microvilli of the small root-and-chip installed; from ovarian and endometrial metastatic adenocarcinoma of the inherent deformation organizations, including the mucin-rich droplets large number of cilia, intensive nuclear particles, these changes In stromal tumor does not exist adenocarcinoma of the rough and short hair.