Where we are mesothelioma (Compensation Mesothelioma} remember the only real precursor the only precursor that could give rise to mesothelioma is asbestos with asbestos who’s your patient maybe a roofer maybe a plumber maybe there was non-environmental maybe you’re washing the clothes of an individual that was uh dealing with asbestos right now what happened next there were two different type of fibers one was the amphibole that was a crocidolite and the other one was the serpentine and that was the crystal when the one that was dangerous was the amphibole okay.
This may then gave rise to mesothelioma this is a malignancy of the pleura associated with asbestosis smoking is not the factor clear so now we have two major lung cancers where smoking is not a factor we have adenocarcinoma a bronchogenic and then mesothelioma but this is dealing with asbestos may result in hemorrhagic pleural exudative effusion thickened pleura let’s take a look at the histology of mesothelioma they might describe the samama body as being calcium deposits is that clear that is a samama body and that of course is completely non-specific you can find that in many cancers including meningioma you can find this in what’s the most common thyroid cancer.
Papillary cancer of the thyroid so you can find this in many here’s mesothelioma as well cytokeratin and what’s known as cal positive and almost all mesotheliomas whereas cal retinin is almost always negative in most carcinomas that’s extremely specific when it comes to mesothelioma one thing that i wish to bring to attention is when it was asbestosis and asbestos what was the pathognomonic lesion that we found in the lung oh yeah that was plural plaque and i told you at that time because there might be plural plaque that it’s not a precursor to mesothelioma I wish to repeat that very statement once again you are involving the pleura here mesothelioma no doubt at the malignancy.
You can expect there to be bloodiness unfortunately lung cancer is the leading cause of mortality from cancer presentation cough hemoptysis bronchial constriction wheezing the mnemonic coin lesion on chest x-ray or non-calcified nodule on CT so coin lesion on x-ray literally looks like one nodule non-calcified nodule on CT the size of metastasis from the lung include adrenal brain bone liver metastasis to the lung from the breast colon prostate bladder cancer liver can be put in there as well okay.
So it’s from the lung to these organs from these organs to the lung breast being a big one complications what may then happen if you have a lung cancer in which while on the right side it causes compression of the supreme vena cava it’s called superior vena cava syndrome and therefore what happens flushing of the face because you can’t drain your upper extremities is that clear do not confuse this with superior sulcus syndrome here the patient is not going to have flushing of the upper face and upper extremity it’s the fact that this patient has a drooping of the eyelid there’s going to be the pupils that are rather tiny and there’s absolutely no sweating what happened.
Well this was a tumor maybe a small cell lung cancer in the apex of the lung understand Pancoast as you see here is not a separate lung cancer do you understand that it is a existing lung cancer that happens to be superior sulcus causing compression of the good sympathetic chain so therefore you unrestricted unregulated parasympathetic activity on the pupil pinpoint people meiosis you’re going to have absolute sympathetic activity on your sweat glands therefore you’re going to have anhidrosis and number three the drupeyalid ptosis welcome to Horner do not forget the other name known as superior sulcus i beg you not to get this confused with super vena cava syndrome where the patient will have flushing in the head and such paraneoplastic syndromes.
We’ve talked about plenty you tell me about adh and acth small cell if it’s pth rp it’ll be squamous cell hoarseness how’s this occurring doc I’m having a hard time well this is going to be laryngeal nerve and as far as effusions are concerned this would be hemorrhagic or bloody either pericardial or pleural. hope you like the Compensation Mesothelioma. read more