Mesothelioma Update

By Mark Block, MD; and Alice M. Boylan, MD

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Clinical Features

The mean age at presentation is 60 years because of the long latency (30 to 40 years, and rarely < 20 years) from the time of exposure to asbestos to the development of clinically evident disease. The incidence is higher in men, presumably because more men have worked in asbestos-related trades. However, it is not uncommon to see women with asbestos-induced mesothelioma whose asbestos exposure has come from exposure their spouses’ contaminated clothing.

Symptoms, signs, and laboratory test results are generally not specific for the disease. Most patients present with aching nonpleuritic chest pain or dyspnea.⁶ Physical examination is usually only remarkable for signs related to the presence of a pleural effusion or mass.

The pleural liquid is usually exudative in nature and is bloody more than half of the time. Cytologic analysis is diagnostic in < 40% of cases.⁷

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