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Early detection of malignant pleural mesothelioma


Malignant pleural mesothelioma (MPM) is a rare tumour. Exposure to asbestos is a well-established aetiological factor for MPM. Patients typically present with shortness of breath due to pleural effusion or chest pain in a more advanced stage. The diagnosis is usually suggested by imaging studies (unilateral pleural thickening; pleural effusion). An occupational history must be obtained. Cytological examination of the effusion can be diagnostic, but often shows equivocal results. Therefore, histology, including immunohistochemistry, is the gold standard. Thoracoscopy, a video-assisted surgical procedure or open pleural biopsy in a fused pleural space may be necessary to provide sufficient material for accurate histological diagnosis. There are three main histological types (epithelial, sarcomatous and mixed) with ~60% being epithelial.

Data suggest the possible contribution of serum mesothelin-related proteins and osteopontin along with others as useful markers to support the diagnosis of mesothelioma; however, the precise role of these markers is yet to be defined.


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Correspondence to Hussein F. Mahmoud PhD, FCCP.

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Mahmoud, H.F. Early detection of malignant pleural mesothelioma. Egypt J Bronchol 8, 1–9 (2014).

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  • Malignant pleural mesothelioma
  • asbestos
  • pleural effusion
  • Thoracoscopy
  • mesothelin
  • osteopontin