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mesotheliomaA neoplasm of serosal surfaces (pleura, peritoneum, pericardium, tunica vaginalis, scrotum) seen in 5–10% of those occupationally exposed to asbestos—especially crocidolite and amosite fibres—with a latency period of 20–40 years. The incidence of mesothelioma increases exponentially if the patient is also a smoker.
Up to 10% of workers heavily exposed to asbestos die from mesothelioma.
Butchart staging of pleural mesothelioma
I—Tumour confined to ipsilateral pleura and lung.
II—Tumour involving contralateral pleura, chest wall, mediastinum, pericardium.
III—Tumour involving both the thorax and abdomen or extrathoracic lymph nodes.
IV—Distant blood-borne metastases.
Proposed TNM staging
• T1—Limited to ipsilateral pleura only;
• T2—Superficial local invasion;
• T3—Deep local invasion;
• T4—Extensive direct invasion.
• N0—No positive lymph node;
• N1—Positive ipsilateral hilar LN;
• N2—Positive mediastinal LN;
• N3—Positive contralateral hilar LN.
• M0—No metastases;
• Ml—Blood-borne or lymphatic metastases.