Zusammenfassung
Das maligne Pleuramesotheliom ist ein seltener Tumor mit schlechter Prognose. In den nächsten Jahren muss mit einer steigenden Inzidenz gerechnet werden. Der Großteil der Pleuramesotheliome wird erst im fortgeschrittenen Stadium diagnostiziert. Typischerweise klagen die Patienten über progrediente Dyspnoe und thorakale Schmerzen. Mittels CT oder MRT können neben einem Pleuraerguss solide pleurale Gewebsvermehrungen und diffuse Pleuraverdickungen dargestellt werden. Dennoch haben beide Untersuchungsverfahren erhebliche Limitationen. Die Diagnose kann nur histologisch-immunhistochemisch an ausreichend großen Gewebeproben gestellt werden. Hier gilt die videoassistierte Thorakoskopie als Goldstandard. Aufgrund der Heterogenität des Tumors ist die Differenzialdiagnose schwierig, insbesondere in Abgrenzung zum Adenokarzinom. Neben benignen Veränderungen müssen sekundäre pleurale Neoplasien bei anderen Tumorentitäten abgegrenzt werden.
Abstract
Malignant pleural mesothelioma is a rare tumor with a poor prognosis. However, an increase in its incidence is to be expected in coming years. The majority of pleural mesotheliomas are diagnosed when they are already at an advanced stage. Patients typically complain of progressive dyspnea and chest pains. In addition to pleural effusions, CT or MRI are able to identify solid pleural tissue formation and diffuse pleural thickening. Nevertheless, both examination procedures have significant limitations. A diagnosis can only be obtained histologically and immunohistochemically using tissue probes of sufficient size. Video-assisted thoracoscopy is considered the gold standard. Due to the heterogeneity of this tumor, the differential diagnosis is complex, particularly its differentiation from adenocarcinoma. In addition to benign lesions, secondary pleural neoplasms need to be distinguished from other tumor entities.
Abbreviations
- AJCC:
-
American Joint Committee on Cancer
- ERS / ESTS:
-
European Respiratory Society / European Society of Thoracic Surgeons
- IMIG:
-
International Mesothelioma Interest Group
- MPM:
-
Malignes Pleuramesotheliom
- MRT:
-
Magnetresonanztomographie
- PET:
-
Positronen-Emissions-Tomographie
- UICC:
-
International Union Against Cancer
- VATS:
-
Videoassistierte Thorakoskopie
- WHO:
-
Weltgesundheitsorganisation
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Sackmann, S. Klinik und Diagnostik des malignen Pleuramesothelioms. Pneumologe 7, 19–27 (2010). https://doi.org/10.1007/s10405-009-0349-6
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DOI: https://doi.org/10.1007/s10405-009-0349-6