Peritoneal mesothelioma is the primary peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on.
Peritoneal mesothelioma is the primary peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on. Peritoneal mesothelioma accounts for about 20% of all mesothelioma cases may occur in 2-92 years, mean age was 54 years, of which about 63% of cases are 45-64 years of age, children are rarely sick.
Medical discovery
Abdominal bulging, or showed a frog abdomen, shifting dullness positive; abdominal palpation can reach sizes of single or multiple mass, general tenderness not obvious, such as associated with pleural mesothelioma, may be found positive signs of pleural effusion.
B-ultrasonography and CT examination, a thin sheet can be found tumor images and ascites, ascites exudate, but also to bloody, hyaluronic acid, such as ascites increased to 120ug/ml, helpful in the diagnosis of ascites to find new Biological diagnosis of mesothelioma cells can also be the middle of the ascites skin cell chromosome analysis, assist in diagnosis and laparoscopic peritoneal surface inspection can be seen covered with nodules and plaques, biopsy pathological examination confirm the diagnosis, needs attention and tuberculous peritonitis, peritoneal metastases phase identification.
Sunday, December 27, 2009
Tuesday, December 22, 2009
A case analysis of the symptoms of peritoneal mesothelioma
Peritoneal mesothelioma originated in the peritoneal epithelium and mesothelial organization whose pathology can be divided into: adenomatoid tumor, cystic mesothelioma, and three kinds of malignant mesothelioma. Peritoneal malignant mesothelioma is a rare malignant tumor, the incidence rate of 1 / 1 million, mostly occurs in middle-aged men and women, incidence of small, its occurrence with exposure to asbestos.
Patients, female, 52 years old, due to "bloating for more than 20 days" on October 21, 2004 into the medicine. Patient for more than 20 days before admission there was no significant incentive to abdominal distention, progressive increase, no fever, night sweats, no abdominal pain, anorexia, no weight loss, no urine, peerless lower extremity edema. Pumping at a local hospital ascites, cancer was not found. Past physical health. Menstruation: 13,7 / 30,48 years of age, color positive, the amount of medium, without dysmenorrhea. Pregnancy history, G2P2L2. Examination: body temperature 36.8 ℃, pulse 84 times / min, breathing 21 times / min, blood pressure 112/80mmHg. Skin and mucosa stained, superficial body lymph nodes are not touched. The normal heart and lung, abdominal bulge, no varicose veins, abdomen soft, no tenderness and rebound tenderness, liver and spleen did not touch, shifting dullness (+). Admission Across gynecological ultrasound examination showed: the uterus and two annexes areas no obvious abnormalities in a large number of ascites. Cancer Series: CA 125> 500u/ml. On October 26, 2004 by Professor gynecological consultations, gynecological examination: development of a normal vulva, vagina smooth, cervix size of the normal, yet smooth. Uterus flat bits, the size of normal activity. After the dome hit small nodules at 1.5cm × 1.0cm. Pairs of non-attachment zone abnormalities, ascites due to some reasons to consider the possibility of Gynecologic Oncology large, in order to confirm the diagnosis, decided to laparoscopic duct exploration, the patient agreed to surgery on October 26, 2004 transferred to gynecology.
Into gynecological after October 28, 2004 in systemic anesthesia laparoscopic duct exploration, intraoperative see the uterus anterior, normal size, bilateral normal-sized ovary, uterus bladder fold milky peritoneal membrane can be seen at large net membrane, intestinal congestion, and other parietal peritoneum. Suck out the yellow ascites 6500ml, in the pelvic parietal peritoneum and the left ovarian biopsy, and membrane-like material will be inspected, the results for the left ovary benign lesions, parietal peritoneum does not rule out malignant mesothelioma, ascites cytology: Cha See cancer (adenocarcinoma). Conditions and their families to talk about tomorrow, is currently not found in patients with intra-abdominal mass in pots and decided to row biopsy and after diagnosis before further treatment. Wash the abdominal cavity, a drainage tube set, a smooth operation, postoperative transfusion and use of antibiotics to prevent infection. Pathological report: malignant peritoneal mesothelioma (The above skin type-based). Immunohistochemistry: MC (+), CK (+), CA125 (-), CA19-9 (-). Postoperative drainage tube patency, a total of 2800ml drain out of ascites, after reviewing routine blood test, liver function, kidney function was normal, after October 18, 2004 ECG monitoring downlink PT regimen, after a smooth, no obvious adverse reaction.
Discussion
Peritoneal mesothelioma originated in the peritoneal epithelium and mesothelial organization whose pathology can be divided into: adenomatoid tumor, cystic mesothelioma, and three kinds of malignant mesothelioma. Peritoneal malignant mesothelioma is a rare malignant tumor, the incidence rate of 1 / 1 million, mostly occurs in middle-aged men and women, incidence of small, its occurrence with exposure to asbestos. It is reported that 60% ~ 80% of patients with asbestos exposure history, a number of cases often without a clear history of asbestos exposure may be related to radiation therapy and chronic peritoneal stimuli. Caused by certain viruses may also cause mesothelioma. Peritoneal mesothelioma clinical manifestations are not specific, the test positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology, as well as pathology, immunohistochemistry and electron microscopy diagnosis of a higher level, more and more cases during his lifetime, or be clearly preoperative pathological diagnosis. Peritoneal mesothelioma should primarily with tuberculous peritonitis, intra-abdominal metastatic carcinoma, other primary in the peritoneum, omentum differentiated from the tumor. To date, peritoneal mesothelioma is still a lack of effects of treatment, the vast majority of scholars, advocates, including surgical resection, postoperative radiotherapy and chemotherapy comprehensive measures. As the case of malignant tumors, where there is unexplained ascites, clinical doctors ruled out ovarian cancer, gastrointestinal cancer of the intra-abdominal metastasis and tuberculosis, peritonitis and other diseases should take into account the possibility of peritoneal malignant mesothelioma should be as soon as possible biopsy or even exploratory laparotomy, a clear diagnosis in order to win treatment time.
Patients, female, 52 years old, due to "bloating for more than 20 days" on October 21, 2004 into the medicine. Patient for more than 20 days before admission there was no significant incentive to abdominal distention, progressive increase, no fever, night sweats, no abdominal pain, anorexia, no weight loss, no urine, peerless lower extremity edema. Pumping at a local hospital ascites, cancer was not found. Past physical health. Menstruation: 13,7 / 30,48 years of age, color positive, the amount of medium, without dysmenorrhea. Pregnancy history, G2P2L2. Examination: body temperature 36.8 ℃, pulse 84 times / min, breathing 21 times / min, blood pressure 112/80mmHg. Skin and mucosa stained, superficial body lymph nodes are not touched. The normal heart and lung, abdominal bulge, no varicose veins, abdomen soft, no tenderness and rebound tenderness, liver and spleen did not touch, shifting dullness (+). Admission Across gynecological ultrasound examination showed: the uterus and two annexes areas no obvious abnormalities in a large number of ascites. Cancer Series: CA 125> 500u/ml. On October 26, 2004 by Professor gynecological consultations, gynecological examination: development of a normal vulva, vagina smooth, cervix size of the normal, yet smooth. Uterus flat bits, the size of normal activity. After the dome hit small nodules at 1.5cm × 1.0cm. Pairs of non-attachment zone abnormalities, ascites due to some reasons to consider the possibility of Gynecologic Oncology large, in order to confirm the diagnosis, decided to laparoscopic duct exploration, the patient agreed to surgery on October 26, 2004 transferred to gynecology.
Into gynecological after October 28, 2004 in systemic anesthesia laparoscopic duct exploration, intraoperative see the uterus anterior, normal size, bilateral normal-sized ovary, uterus bladder fold milky peritoneal membrane can be seen at large net membrane, intestinal congestion, and other parietal peritoneum. Suck out the yellow ascites 6500ml, in the pelvic parietal peritoneum and the left ovarian biopsy, and membrane-like material will be inspected, the results for the left ovary benign lesions, parietal peritoneum does not rule out malignant mesothelioma, ascites cytology: Cha See cancer (adenocarcinoma). Conditions and their families to talk about tomorrow, is currently not found in patients with intra-abdominal mass in pots and decided to row biopsy and after diagnosis before further treatment. Wash the abdominal cavity, a drainage tube set, a smooth operation, postoperative transfusion and use of antibiotics to prevent infection. Pathological report: malignant peritoneal mesothelioma (The above skin type-based). Immunohistochemistry: MC (+), CK (+), CA125 (-), CA19-9 (-). Postoperative drainage tube patency, a total of 2800ml drain out of ascites, after reviewing routine blood test, liver function, kidney function was normal, after October 18, 2004 ECG monitoring downlink PT regimen, after a smooth, no obvious adverse reaction.
Discussion
Peritoneal mesothelioma originated in the peritoneal epithelium and mesothelial organization whose pathology can be divided into: adenomatoid tumor, cystic mesothelioma, and three kinds of malignant mesothelioma. Peritoneal malignant mesothelioma is a rare malignant tumor, the incidence rate of 1 / 1 million, mostly occurs in middle-aged men and women, incidence of small, its occurrence with exposure to asbestos. It is reported that 60% ~ 80% of patients with asbestos exposure history, a number of cases often without a clear history of asbestos exposure may be related to radiation therapy and chronic peritoneal stimuli. Caused by certain viruses may also cause mesothelioma. Peritoneal mesothelioma clinical manifestations are not specific, the test positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology, as well as pathology, immunohistochemistry and electron microscopy diagnosis of a higher level, more and more cases during his lifetime, or be clearly preoperative pathological diagnosis. Peritoneal mesothelioma should primarily with tuberculous peritonitis, intra-abdominal metastatic carcinoma, other primary in the peritoneum, omentum differentiated from the tumor. To date, peritoneal mesothelioma is still a lack of effects of treatment, the vast majority of scholars, advocates, including surgical resection, postoperative radiotherapy and chemotherapy comprehensive measures. As the case of malignant tumors, where there is unexplained ascites, clinical doctors ruled out ovarian cancer, gastrointestinal cancer of the intra-abdominal metastasis and tuberculosis, peritonitis and other diseases should take into account the possibility of peritoneal malignant mesothelioma should be as soon as possible biopsy or even exploratory laparotomy, a clear diagnosis in order to win treatment time.
Sunday, December 20, 2009
More than one third the incidence of smoking-related cancers
Reporter learned from the Tianjin Tumor Hospital, China about 100 million people die each year from smoking related diseases, deaths due to passive smoking disease more than 10 million, and passive smoking hazards awareness rate was only 35%.
In recent years, a gradual increase in the incidence of malignant tumors, the occurrence of more than one third of cancer associated with smoking, has become a threat to the health of urban and rural residents of China's number one killer. In addition to lung cancer most closely associated with smoking, the smoke will be on the larynx, oral cavity, tongue, esophagus, stomach, pancreas, bladder, kidney, and the incidence of cervical cancer and so on have an impact.
Chinese Academy of Engineering, Tianjin Cancer Hospital, said Professor Hao Xishan, active smoking and passive smoking-induced cancers will be. Secondhand smoke contains more than 40 kinds of cancer-related toxic substances. In China, the main victims of passive smoking are women and children.
HAO Xi-shan to remind you that quitting smoking is the most effective cancer prevention methods. For smokers, the early quit smoking better than later, even if the middle-age smoking, will also reduce the risk of cancer.
In recent years, a gradual increase in the incidence of malignant tumors, the occurrence of more than one third of cancer associated with smoking, has become a threat to the health of urban and rural residents of China's number one killer. In addition to lung cancer most closely associated with smoking, the smoke will be on the larynx, oral cavity, tongue, esophagus, stomach, pancreas, bladder, kidney, and the incidence of cervical cancer and so on have an impact.
Chinese Academy of Engineering, Tianjin Cancer Hospital, said Professor Hao Xishan, active smoking and passive smoking-induced cancers will be. Secondhand smoke contains more than 40 kinds of cancer-related toxic substances. In China, the main victims of passive smoking are women and children.
HAO Xi-shan to remind you that quitting smoking is the most effective cancer prevention methods. For smokers, the early quit smoking better than later, even if the middle-age smoking, will also reduce the risk of cancer.
Thursday, December 17, 2009
Going into detail in food "tumor factor"
San Francisco VA Medical Center director of Cell Growth Laboratory, U.S. Department of Health under the Department of Veterans Affairs of the Science Advisor, the study's chief scientist, Millie Hughes-Fulford, Dr. said: "The arachidonic acid is the omega-6 family of well-known members. omega-6 fatty acids can open a direct pathway to promote tumor growth. "
The results of this study was published in February of this year's "Cancer Research" on.
University of California, San Francisco for part-time professor at Hughes-Fulford said: "When we put omega-6 fatty acids added to the cell growth medium, we observed that tumor growth rate was double the control."
She further added: "In the study of why the rate of tumor growth so fast, we found that omega-6 can open a number of inflammatory genes, these genes now known to be important cancer-related genes. We continue to ask what to open these genes, eventually found that omega-6 fatty acids can indeed open the named P13 kinase signaling pathway, the enzyme in cancer played an important role. "
Hughes-Fulford believe that this result has important significance, because the modern American's daily diet omega-6 fatty acids, very high quality. omega-6 only existed squeeze the oil of vegetable seeds, such as corn oil, omega-6 fatty acid content was 25 times the health standards, in addition to canola oil, fish and green vegetables all contain omega-6 fatty acids. She also mentioned that in the past 60 years, the United States the incidence of prostate cancer has been growing steadily, which is omega-6 intake increase the same, a fact that diet and prostate cancer suggests a possible link.
The research is based on Fulford and her research team had some of the work, they found that arachidonic acid can stimulate the kind of enzyme known as cPLA-2 generation, and this enzyme would lead to the occurrence of a series of biochemical reaction chain , eventually leading to tumor growth. Mentioned in the previous text of the article, the researchers "along the trace the origin of this biochemical cascade upstream," Hughes-Fulford said: "These fatty acids is to activate signaling pathways, triggering a whole cascade of initiator. "
Hughes-Fulford and her colleagues also found that if they are added to the tumor cell culture of non-steroidal anti-inflammatory factor, or PI3K inhibitor, it will undermine the signaling pathway, these genes will not be opened, tumor growth did not accelerate occur.
Currently, Hughes-Fulford experimental animals to continue her studies, she had her experimental animals take different levels of omega-3 fatty acids and omega-6 fatty acids, observed, "the growth of tumors in animals how well."
Hughes-Fulford said she was a direct impact on the findings of her own daily diet, "I am not a doctor, and can not tell people how to eat is healthy, but I can tell you how to do it myself." She added : "I just eat canola oil and olive oil, we have the right deep-fried foods at arm's length."
The results of this study was published in February of this year's "Cancer Research" on.
University of California, San Francisco for part-time professor at Hughes-Fulford said: "When we put omega-6 fatty acids added to the cell growth medium, we observed that tumor growth rate was double the control."
She further added: "In the study of why the rate of tumor growth so fast, we found that omega-6 can open a number of inflammatory genes, these genes now known to be important cancer-related genes. We continue to ask what to open these genes, eventually found that omega-6 fatty acids can indeed open the named P13 kinase signaling pathway, the enzyme in cancer played an important role. "
Hughes-Fulford believe that this result has important significance, because the modern American's daily diet omega-6 fatty acids, very high quality. omega-6 only existed squeeze the oil of vegetable seeds, such as corn oil, omega-6 fatty acid content was 25 times the health standards, in addition to canola oil, fish and green vegetables all contain omega-6 fatty acids. She also mentioned that in the past 60 years, the United States the incidence of prostate cancer has been growing steadily, which is omega-6 intake increase the same, a fact that diet and prostate cancer suggests a possible link.
The research is based on Fulford and her research team had some of the work, they found that arachidonic acid can stimulate the kind of enzyme known as cPLA-2 generation, and this enzyme would lead to the occurrence of a series of biochemical reaction chain , eventually leading to tumor growth. Mentioned in the previous text of the article, the researchers "along the trace the origin of this biochemical cascade upstream," Hughes-Fulford said: "These fatty acids is to activate signaling pathways, triggering a whole cascade of initiator. "
Hughes-Fulford and her colleagues also found that if they are added to the tumor cell culture of non-steroidal anti-inflammatory factor, or PI3K inhibitor, it will undermine the signaling pathway, these genes will not be opened, tumor growth did not accelerate occur.
Currently, Hughes-Fulford experimental animals to continue her studies, she had her experimental animals take different levels of omega-3 fatty acids and omega-6 fatty acids, observed, "the growth of tumors in animals how well."
Hughes-Fulford said she was a direct impact on the findings of her own daily diet, "I am not a doctor, and can not tell people how to eat is healthy, but I can tell you how to do it myself." She added : "I just eat canola oil and olive oil, we have the right deep-fried foods at arm's length."
Tuesday, December 15, 2009
Peritoneal mesothelioma
Peritoneal mesothelioma is the primary peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on.
Overview of primary peritoneal mesothelioma is peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on. Peritoneal mesothelioma accounts for about 20% of all mesothelioma cases may occur in 2-92 years, mean age was 54 years, of which about 63% of cases are 45-64 years of age, children are rarely sick.
Clinical manifestations 1. Abdominal pain, abdominal distention, ascites, abdominal mass; 2. Anorexia, nausea, vomiting, diarrhea, constipation; 3. Fatigue, fever, weight loss, anemia; 4. Low blood sugar, diffuse abdominal ossification; 5. other parts of the merger, such as mesothelioma, peritoneal mesothelioma, metastasis to other organs and complications of the corresponding performance. Based on a diagnosis. Abdominal pain, abdominal distention, ascites, abdominal mass in patients, especially those with asbestos exposure history; 2. Imaging studies have a thin sheet of peritoneal signs and ascites tumor; 3. Ascites cytology; 4. Peritoneal biopsy, laparoscopy and laparotomy and pathological examination can be taken to make the organization confirmed.
Treatment principles 1. Surgical treatment; 2. Radiotherapy; 3. Chemotherapy; 4. Symptomatic supportive care. The principle of a medication. Combination therapy (such as cis-platinum + cyclophosphamide + vincristine), with intraperitoneal injection of chemotherapy drugs (such as cis-platinum); 2. Intra-abdominal injection of 32P, or colloidal gold, radiotherapy and chemotherapy drugs; 3. surgical cases can not be removed using radiotherapy (60Co) and chemotherapy (cyclophosphamide, vincristine, dactinomycin, etc.). Auxiliary examination 1. Check box limit "A" will help other than confusing the disease; 2. Check box limit "B" will help diagnosis.
Evaluation of a. Cure: remove the tumor without complications, wound healing, clinical symptoms disappeared; 2. Improved: radiotherapy, chemotherapy, symptoms improved after the tumor shrink or slow down the growth rate, appetite improved, weight gain; 3. Unhealed: clinical symptoms and signs do not disappear. Expert Tips peritoneal mesothelioma originated in the peritoneal epithelium and mesothelial organizations, asbestos dust for the disease-causing substances, may also be caused by certain viruses causes of mesothelioma.
Pathology of peritoneal mesothelioma can be divided into: adenomatoid tumor, cystic mesothelioma, and three kinds of malignant mesothelioma. Peritoneal mesothelioma clinical manifestations are not specific, the test positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology, carry out, as well as pathology, immunohistochemistry and electron microscopy diagnosis of a higher level, more and more cases during his lifetime, or be clearly preoperative pathological diagnosis. Peritoneal mesothelioma should primarily with tuberculous peritonitis, intra-abdominal metastatic carcinoma, other primary tumors in the peritoneal omentum phase identification. To date, peritoneal mesothelioma is still a lack of effects of treatment, the vast majority of scholars, advocates, including surgical resection, postoperative radiotherapy and chemotherapy comprehensive treatment measures.
Overview of primary peritoneal mesothelioma is peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on. Peritoneal mesothelioma accounts for about 20% of all mesothelioma cases may occur in 2-92 years, mean age was 54 years, of which about 63% of cases are 45-64 years of age, children are rarely sick.
Clinical manifestations 1. Abdominal pain, abdominal distention, ascites, abdominal mass; 2. Anorexia, nausea, vomiting, diarrhea, constipation; 3. Fatigue, fever, weight loss, anemia; 4. Low blood sugar, diffuse abdominal ossification; 5. other parts of the merger, such as mesothelioma, peritoneal mesothelioma, metastasis to other organs and complications of the corresponding performance. Based on a diagnosis. Abdominal pain, abdominal distention, ascites, abdominal mass in patients, especially those with asbestos exposure history; 2. Imaging studies have a thin sheet of peritoneal signs and ascites tumor; 3. Ascites cytology; 4. Peritoneal biopsy, laparoscopy and laparotomy and pathological examination can be taken to make the organization confirmed.
Treatment principles 1. Surgical treatment; 2. Radiotherapy; 3. Chemotherapy; 4. Symptomatic supportive care. The principle of a medication. Combination therapy (such as cis-platinum + cyclophosphamide + vincristine), with intraperitoneal injection of chemotherapy drugs (such as cis-platinum); 2. Intra-abdominal injection of 32P, or colloidal gold, radiotherapy and chemotherapy drugs; 3. surgical cases can not be removed using radiotherapy (60Co) and chemotherapy (cyclophosphamide, vincristine, dactinomycin, etc.). Auxiliary examination 1. Check box limit "A" will help other than confusing the disease; 2. Check box limit "B" will help diagnosis.
Evaluation of a. Cure: remove the tumor without complications, wound healing, clinical symptoms disappeared; 2. Improved: radiotherapy, chemotherapy, symptoms improved after the tumor shrink or slow down the growth rate, appetite improved, weight gain; 3. Unhealed: clinical symptoms and signs do not disappear. Expert Tips peritoneal mesothelioma originated in the peritoneal epithelium and mesothelial organizations, asbestos dust for the disease-causing substances, may also be caused by certain viruses causes of mesothelioma.
Pathology of peritoneal mesothelioma can be divided into: adenomatoid tumor, cystic mesothelioma, and three kinds of malignant mesothelioma. Peritoneal mesothelioma clinical manifestations are not specific, the test positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology, carry out, as well as pathology, immunohistochemistry and electron microscopy diagnosis of a higher level, more and more cases during his lifetime, or be clearly preoperative pathological diagnosis. Peritoneal mesothelioma should primarily with tuberculous peritonitis, intra-abdominal metastatic carcinoma, other primary tumors in the peritoneal omentum phase identification. To date, peritoneal mesothelioma is still a lack of effects of treatment, the vast majority of scholars, advocates, including surgical resection, postoperative radiotherapy and chemotherapy comprehensive treatment measures.
Sunday, December 13, 2009
Peritoneal mesothelioma should be how is it treated?
(A) treatment
The effect of radiotherapy and chemotherapy in general are dissatisfied with some reports in recent years, treatment with adriamycin, 50% of cases extended the survival time but there are also reports that some people advocate the use of ineffective immune therapy requires further observation is generally 1 to 2 years after diagnosis the death date So far peritoneal mesothelioma is still a lack of standardized treatment for the vast majority of scholars, advocates, including radiotherapy and chemotherapy after surgical removal of a comprehensive treatment of
1. Surgical treatment for stage of disease are cases of stage Ⅰ Stage Ⅱ surgical treatment should still be the preferred or to gain, including surgical resection Palliative resection of the tumor lesions smaller than its predecessor should complete resection of tumor and involved organs; if more extensive lesions should seek to remove the main tumor (palliative resection) on the disease has caused widespread and serious intestinal surgery can not be considered palliative resection surgery to relieve the patient's clinical symptoms and biological behavior of benign low-grade malignant peritoneal mesothelioma Surgical resection can be very good if re-resection recurrence Zhu Wei-qi and other reports one cases of malignant peritoneal mesothelioma 20 years because of repeated recurrence of surgical resection has implemented five times reported in the literature surgical resection alone a set of best cases (7 cases ), the median survival period of 147.2 months and therefore some cases of peritoneal mesothelioma, surgery is still regarded as effective treatment
2. Radiotherapy, including external beam radiotherapy and (or) irradiation can choose 60Co or 186 kV X-ray radiation source, as applicable to incomplete resection or unresectable disease cases Keyi range determines the full abdominal irradiation or local irradiation is generally believed that peritoneal pleural mesothelioma, mesothelioma radiation therapy as effective as a good which may be related pleural mesothelioma, a larger dose of radiation used in the Shanghai Medical University Cancer Hospital data show that the whole abdominal irradiation dose per 6 ~ 7 weeks 2400cGy patients with local recurrence rate can be fell to 11.4% three-year survival rate was 66.7% shows the effect of radiotherapy on peritoneal mesothelioma is in the affirmative
3. Chemotherapy on reports of chemotherapy in the treatment of peritoneal mesothelioma, peritoneal mesothelioma, many now considered moderately sensitive to chemotherapy is commonly used drugs: doxorubicin (ADM) and cisplatin (DDP) vincristine (VCR) ring phosphorus amide (CTX) bleomycin (BLM), as well as domestic anti-cancer drugs such as mixing elements of which the fragrant milk over the efficacy of doxorubicin chemotherapy is most certainly is divided into systemic chemotherapy and intraperitoneal chemotherapy
(1) systemic chemotherapy: systemic anti-cancer drugs given to the distribution of drugs after the intra-abdominal foreign data show that less whether single agent or combination therapy with chemotherapy effective only 11% ~ 14% of combined chemotherapy, including: DDP + ADM; DDP + CTX + VCR; CTX + VCR + BLM, etc. However, many scholars have pointed out and would not improve efficacy of combination chemotherapy
(2) Intraperitoneal chemotherapy: In recent years that the intraperitoneal injection drug use can increase local drug concentration to reduce systemic adverse reactions of doxorubicin intraperitoneal chemotherapy can not only eliminate residual tumor tissue after surgery to reduce recurrence and also enable some patients to lose the opportunity to tumor surgery reduce the disease has been effectively controlled with ascites to reduce intra-abdominal and intravenous dose once a dosage similar to or slightly higher than the latter to repeat the condition of patients after 1 week of continuous injection of Ito and so on for several weeks to one cases of surgical resection for patients unable to intraperitoneal injection of DDP and jointly with the of uracil and tegafur 223 days after the patients had no abdominal mass ascites completely disappeared but in the first 8 months after the recurrence of pelvic masses re-DDP and camptothecin effect is given to poor Ma and so on are continuous hyperthermic peritoneal perfusion with heat (continuous hyperthermic peritoneal perfusionCHPP) local injection of DDP combined treatment of primary peritoneal mesothelioma course of treatment, no significant local adverse reactions CHPP Patients are able to withstand 10 months of follow-up of non-one cases of death due to CHPP treatment
33P intraperitoneal injection in the treatment of peritoneal mesothelioma, there is a certain effect has been reported by injection of 33P intracavitary radiotherapy and cyclophosphamide in the treatment of malignant peritoneal mesothelioma patients survive up to 17 years are also useful in the treatment of intraperitoneal injection of radioactive colloid reports
4. Biological response modifier biological response modifier (biological nesponse modifierBRM) is to apply some of the body's own cellular and molecular responses to stimulate the body's internal and external environment and thus to participate to maintain the stability of the body environment, through the mobilization of the body BRM inherent capacity to resist and eliminate cancer as Today a new model for tumor therapy
Cytokine interleukin (IL) interferon (IFN) tumor necrosis factor (TNF), etc. In addition to directly kill the tumor cells outside the body and can be activated anti-cancer effects against cancer cells or secreted factors or the maintenance of immune effector cell proliferation and differentiation of function as adjuvant treatment of primary peritoneal mesothelioma
Adoptive transfer of immune cells collected in the separation of lymphocytes in malignant ascites, and induced in vitro expansion of activity with the anti-Lymphokine-activated killer (LAK) will be injected into the body of the tumor cells, anti-IL-2 can be given at the same time improve the efficacy of
(B) the prognosis
Treatment of malignant peritoneal mesothelioma, if not the majority in the survival after diagnosis is only one more than a year died from cachexia or small-bowel obstruction cytoreductive surgery and complete intra-abdominal chemotherapy to improve treatment methods such as direct impact on the prognosis of patients has been reported cytoreductive surgery and intraperitoneal chemotherapy Multi-method combination therapy to peritoneal mesothelioma, the average survival time of up to 50 to 60 months among women in relatively good prognosis of the biological behavior of tumor itself also has important prognostic significance of a group of 4710 cases reported in the literature the analysis of data indicate that epithelial mixed-type and fiber type in the median survival of 11 months, respectively 10 months and 5 months
The effect of radiotherapy and chemotherapy in general are dissatisfied with some reports in recent years, treatment with adriamycin, 50% of cases extended the survival time but there are also reports that some people advocate the use of ineffective immune therapy requires further observation is generally 1 to 2 years after diagnosis the death date So far peritoneal mesothelioma is still a lack of standardized treatment for the vast majority of scholars, advocates, including radiotherapy and chemotherapy after surgical removal of a comprehensive treatment of
1. Surgical treatment for stage of disease are cases of stage Ⅰ Stage Ⅱ surgical treatment should still be the preferred or to gain, including surgical resection Palliative resection of the tumor lesions smaller than its predecessor should complete resection of tumor and involved organs; if more extensive lesions should seek to remove the main tumor (palliative resection) on the disease has caused widespread and serious intestinal surgery can not be considered palliative resection surgery to relieve the patient's clinical symptoms and biological behavior of benign low-grade malignant peritoneal mesothelioma Surgical resection can be very good if re-resection recurrence Zhu Wei-qi and other reports one cases of malignant peritoneal mesothelioma 20 years because of repeated recurrence of surgical resection has implemented five times reported in the literature surgical resection alone a set of best cases (7 cases ), the median survival period of 147.2 months and therefore some cases of peritoneal mesothelioma, surgery is still regarded as effective treatment
2. Radiotherapy, including external beam radiotherapy and (or) irradiation can choose 60Co or 186 kV X-ray radiation source, as applicable to incomplete resection or unresectable disease cases Keyi range determines the full abdominal irradiation or local irradiation is generally believed that peritoneal pleural mesothelioma, mesothelioma radiation therapy as effective as a good which may be related pleural mesothelioma, a larger dose of radiation used in the Shanghai Medical University Cancer Hospital data show that the whole abdominal irradiation dose per 6 ~ 7 weeks 2400cGy patients with local recurrence rate can be fell to 11.4% three-year survival rate was 66.7% shows the effect of radiotherapy on peritoneal mesothelioma is in the affirmative
3. Chemotherapy on reports of chemotherapy in the treatment of peritoneal mesothelioma, peritoneal mesothelioma, many now considered moderately sensitive to chemotherapy is commonly used drugs: doxorubicin (ADM) and cisplatin (DDP) vincristine (VCR) ring phosphorus amide (CTX) bleomycin (BLM), as well as domestic anti-cancer drugs such as mixing elements of which the fragrant milk over the efficacy of doxorubicin chemotherapy is most certainly is divided into systemic chemotherapy and intraperitoneal chemotherapy
(1) systemic chemotherapy: systemic anti-cancer drugs given to the distribution of drugs after the intra-abdominal foreign data show that less whether single agent or combination therapy with chemotherapy effective only 11% ~ 14% of combined chemotherapy, including: DDP + ADM; DDP + CTX + VCR; CTX + VCR + BLM, etc. However, many scholars have pointed out and would not improve efficacy of combination chemotherapy
(2) Intraperitoneal chemotherapy: In recent years that the intraperitoneal injection drug use can increase local drug concentration to reduce systemic adverse reactions of doxorubicin intraperitoneal chemotherapy can not only eliminate residual tumor tissue after surgery to reduce recurrence and also enable some patients to lose the opportunity to tumor surgery reduce the disease has been effectively controlled with ascites to reduce intra-abdominal and intravenous dose once a dosage similar to or slightly higher than the latter to repeat the condition of patients after 1 week of continuous injection of Ito and so on for several weeks to one cases of surgical resection for patients unable to intraperitoneal injection of DDP and jointly with the of uracil and tegafur 223 days after the patients had no abdominal mass ascites completely disappeared but in the first 8 months after the recurrence of pelvic masses re-DDP and camptothecin effect is given to poor Ma and so on are continuous hyperthermic peritoneal perfusion with heat (continuous hyperthermic peritoneal perfusionCHPP) local injection of DDP combined treatment of primary peritoneal mesothelioma course of treatment, no significant local adverse reactions CHPP Patients are able to withstand 10 months of follow-up of non-one cases of death due to CHPP treatment
33P intraperitoneal injection in the treatment of peritoneal mesothelioma, there is a certain effect has been reported by injection of 33P intracavitary radiotherapy and cyclophosphamide in the treatment of malignant peritoneal mesothelioma patients survive up to 17 years are also useful in the treatment of intraperitoneal injection of radioactive colloid reports
4. Biological response modifier biological response modifier (biological nesponse modifierBRM) is to apply some of the body's own cellular and molecular responses to stimulate the body's internal and external environment and thus to participate to maintain the stability of the body environment, through the mobilization of the body BRM inherent capacity to resist and eliminate cancer as Today a new model for tumor therapy
Cytokine interleukin (IL) interferon (IFN) tumor necrosis factor (TNF), etc. In addition to directly kill the tumor cells outside the body and can be activated anti-cancer effects against cancer cells or secreted factors or the maintenance of immune effector cell proliferation and differentiation of function as adjuvant treatment of primary peritoneal mesothelioma
Adoptive transfer of immune cells collected in the separation of lymphocytes in malignant ascites, and induced in vitro expansion of activity with the anti-Lymphokine-activated killer (LAK) will be injected into the body of the tumor cells, anti-IL-2 can be given at the same time improve the efficacy of
(B) the prognosis
Treatment of malignant peritoneal mesothelioma, if not the majority in the survival after diagnosis is only one more than a year died from cachexia or small-bowel obstruction cytoreductive surgery and complete intra-abdominal chemotherapy to improve treatment methods such as direct impact on the prognosis of patients has been reported cytoreductive surgery and intraperitoneal chemotherapy Multi-method combination therapy to peritoneal mesothelioma, the average survival time of up to 50 to 60 months among women in relatively good prognosis of the biological behavior of tumor itself also has important prognostic significance of a group of 4710 cases reported in the literature the analysis of data indicate that epithelial mixed-type and fiber type in the median survival of 11 months, respectively 10 months and 5 months
Thursday, December 10, 2009
Histological types of peritoneal mesothelioma
Membrane mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).
Malignant mesothelioma is also known as "mesothelial sarcoma." Mostly occurs in the pleura and peritoneum, testis sheath, pericardium, meninges. More men than women, the ratio of 1.33:1. Occurs can be divided into parts according to the limitations and diffuse types. Limitations may have good evil points, both diffuse malignant. Among them, mostly diffuse peritoneal and pericardial. Low incidence of malignant mesothelioma, clinical rare.
Peritoneal mesothelioma histologic sub-three types: epithelial 15%, connective tissue-type 25%, mixed 60%. Longitudinal spread along the peritoneal surface lesion showed growth and invasion, and less distant metastasis, multi-spread along the serosa to the adjacent organs, involving the adjacent serous cavity; dual lymph node metastasis may occur; distant metastasis. Particularly prevalent in the hepatopulmonary bone. This case is almost are evil CT of peritoneal mesothelioma, symptoms of non-specific and therefore difficult early diagnosis. The main symptoms were (1), abdominal pain, generally expressed as a fixed part of the dull pain. (2) abdominal mass. (3) of the patients have incomplete obstruction. (4) ascites is a common symptom, and many more abdominal distension with ascites treatment. (5) late shows weakness, weight loss, weight loss, more than half a year were found; a minimum of two weeks. Easy-to-tissue adhesion tumor removal surgery is not easy.
CT manifestations of its performance, often as follows: (1) ascites, the amount of the number of ranges, and often bloody. (2), diffuse peritoneal thickening, thickening of the omentum and mesentery density increased, and some may have calcification, mesangial shadow blurred between the blood vessels. (3), nodule or mass formation, in the backdrop of ascites nodules more clearly, especially in the liver margin of spleen edge more pronounced. (4), omentum, or mesentery tumor was tie-shaped cakes, mesenteric stiffness, shrinkage star-shaped radiation bowels into a fan-shaped distribution of the fixed focus. But not its unique, ovarian, colon, pancreas, and mesenteric lymphoma may be represented by similar change.
Malignant mesothelioma is also known as "mesothelial sarcoma." Mostly occurs in the pleura and peritoneum, testis sheath, pericardium, meninges. More men than women, the ratio of 1.33:1. Occurs can be divided into parts according to the limitations and diffuse types. Limitations may have good evil points, both diffuse malignant. Among them, mostly diffuse peritoneal and pericardial. Low incidence of malignant mesothelioma, clinical rare.
Peritoneal mesothelioma histologic sub-three types: epithelial 15%, connective tissue-type 25%, mixed 60%. Longitudinal spread along the peritoneal surface lesion showed growth and invasion, and less distant metastasis, multi-spread along the serosa to the adjacent organs, involving the adjacent serous cavity; dual lymph node metastasis may occur; distant metastasis. Particularly prevalent in the hepatopulmonary bone. This case is almost are evil CT of peritoneal mesothelioma, symptoms of non-specific and therefore difficult early diagnosis. The main symptoms were (1), abdominal pain, generally expressed as a fixed part of the dull pain. (2) abdominal mass. (3) of the patients have incomplete obstruction. (4) ascites is a common symptom, and many more abdominal distension with ascites treatment. (5) late shows weakness, weight loss, weight loss, more than half a year were found; a minimum of two weeks. Easy-to-tissue adhesion tumor removal surgery is not easy.
CT manifestations of its performance, often as follows: (1) ascites, the amount of the number of ranges, and often bloody. (2), diffuse peritoneal thickening, thickening of the omentum and mesentery density increased, and some may have calcification, mesangial shadow blurred between the blood vessels. (3), nodule or mass formation, in the backdrop of ascites nodules more clearly, especially in the liver margin of spleen edge more pronounced. (4), omentum, or mesentery tumor was tie-shaped cakes, mesenteric stiffness, shrinkage star-shaped radiation bowels into a fan-shaped distribution of the fixed focus. But not its unique, ovarian, colon, pancreas, and mesenteric lymphoma may be represented by similar change.
Monday, December 7, 2009
Peritoneal mesothelioma should be how to prevent?
Peritoneal mesothelioma originated in the peritoneal mesothelial epithelium and the organization of asbestos dust as a pathogenic substances may also be caused by certain viruses cause mesothelioma, the active prevention of occupational diseases (such as textiles and construction) is the key to prevention of this disease for the cause of strengthening the protection to improve the the working environment from the source to prevent the occurrence of the disease
Saturday, December 5, 2009
Peritoneal mesothelioma can be complicated by the diseases?
Gastrointestinal dysfunction in pleural mesothelioma patients with advanced ascites spontaneous hypoglycemia can occur systemic symptoms such as weakness and wasting a huge number of abdominal swelling and ascites can occur a large number of compression symptoms such as breathing trouble or difficulties in lower leg swelling, urinary symptoms such as poor
Thursday, December 3, 2009
Peritoneal mesothelioma with which the disease easily confused?
Peritoneal mesothelioma should be tuberculous peritonitis intra-abdominal metastatic tumors of other primary tumors in the peritoneum and omentum differentiated from
1. Tuberculous peritonitis malignant peritoneal mesothelioma misdiagnosed as tubercular peritonitis and to the anti-tuberculosis treatment of patients frequently reported that due to anti-tuberculosis treatment after the invalid line laparotomy side of tuberculous peritonitis diagnosed in middle-aged general, mostly among the clinical ascites with abdominal pain and abdominal mass, abdominal distention fever outside the common clinical manifestations of PPD-positive erythrocyte sedimentation rate (erythrocyte sedimentation rateESR ESR) increased rapidly to support the diagnosis of tuberculous peritonitis with ascites in tuberculous peritonitis exudates for multiple single-core ascites cell-based training, such as PCR examination and smears for differential diagnosis of tuberculosis was found significant ascites adenosine deaminase (adenosine deaminaseADA) increased activity may be determined tuberculous peritonitis ascites lactate dehydrogenase (LDH) will definitely be helpful in differentiating ascites and serum LDH ratio is greater than the value of a prompt for malignant ascites clinically highly suspected cases of tuberculous peritonitis in close observation of anti-TB treatment on the downlink regular anti-TB treatment ineffective, or both should be fighting for the differential diagnosis of difficult early by laparoscopy or surgical exploration caseous granulomas were found on pathology is easy to identify with peritoneal mesothelioma
2. Peritoneal metastatic tumors from gastric cancer peritoneal metastases of ovarian cancer, pancreatic cancer often liver and colon cancer, etc. pseudomyxoma peritonei which is often due to rupture of ovarian mucinous cystadenoma peritoneal cause (also by the rupture of the appendix, or pancreas cyst cause) showed swelling of intra-abdominal mass in the ascites ascites was jelly mucus when the primary tumor when the clinical manifestations of occult peritoneal metastases and peritoneal mesothelioma, is difficult to identify ascites cytology can improve if the right way and the false positive rate find a few positive cells, such as peritoneal carcinomatosis with ascites can be diagnosed by means of Digestive Endoscopy and upper gastrointestinal contrast abdominal pelvic ultrasound and CT scan of blood AFP and other related carbohydrate antigen detection of cancer and even laparoscopy in order to carefully search for the primary tumor and sometimes even if the above-mentioned Clinical examination found no primary tumor can not be completely ruled out on the abdominal pelvic lesions and metastatic tumors may be pathological examination should pay attention to mesothelioma and metastatic adenocarcinoma and the source of epithelial ovarian tumors to distinguish the differential difficulties should be made by immunohistochemistry or electron microscopy examination
3. Other primary malignant tumors in the peritoneal peritoneal serous borderline tumors also known as atypical tubal endometriosis of primary peritoneal papillary tumors and low-grade peritoneal serous small papillomatosis is a rare primary in the peritoneal lesions often occur in women of any age may be involved in most patients under the age of 40 main symptoms are abdominal or pelvic pain symptoms of chronic pelvic inflammatory disease and even pathological phenomena of adhesion, or amenorrhea, can be made with peritoneal mesothelioma the differential diagnosis of this disease a better prognosis
Other primary tumors in the peritoneal adenocarcinoma fibrosarcoma liposarcoma is very rare and so hard to reconcile with the clinical distinction between peritoneal mesothelioma are mostly found in the autopsy
1. Tuberculous peritonitis malignant peritoneal mesothelioma misdiagnosed as tubercular peritonitis and to the anti-tuberculosis treatment of patients frequently reported that due to anti-tuberculosis treatment after the invalid line laparotomy side of tuberculous peritonitis diagnosed in middle-aged general, mostly among the clinical ascites with abdominal pain and abdominal mass, abdominal distention fever outside the common clinical manifestations of PPD-positive erythrocyte sedimentation rate (erythrocyte sedimentation rateESR ESR) increased rapidly to support the diagnosis of tuberculous peritonitis with ascites in tuberculous peritonitis exudates for multiple single-core ascites cell-based training, such as PCR examination and smears for differential diagnosis of tuberculosis was found significant ascites adenosine deaminase (adenosine deaminaseADA) increased activity may be determined tuberculous peritonitis ascites lactate dehydrogenase (LDH) will definitely be helpful in differentiating ascites and serum LDH ratio is greater than the value of a prompt for malignant ascites clinically highly suspected cases of tuberculous peritonitis in close observation of anti-TB treatment on the downlink regular anti-TB treatment ineffective, or both should be fighting for the differential diagnosis of difficult early by laparoscopy or surgical exploration caseous granulomas were found on pathology is easy to identify with peritoneal mesothelioma
2. Peritoneal metastatic tumors from gastric cancer peritoneal metastases of ovarian cancer, pancreatic cancer often liver and colon cancer, etc. pseudomyxoma peritonei which is often due to rupture of ovarian mucinous cystadenoma peritoneal cause (also by the rupture of the appendix, or pancreas cyst cause) showed swelling of intra-abdominal mass in the ascites ascites was jelly mucus when the primary tumor when the clinical manifestations of occult peritoneal metastases and peritoneal mesothelioma, is difficult to identify ascites cytology can improve if the right way and the false positive rate find a few positive cells, such as peritoneal carcinomatosis with ascites can be diagnosed by means of Digestive Endoscopy and upper gastrointestinal contrast abdominal pelvic ultrasound and CT scan of blood AFP and other related carbohydrate antigen detection of cancer and even laparoscopy in order to carefully search for the primary tumor and sometimes even if the above-mentioned Clinical examination found no primary tumor can not be completely ruled out on the abdominal pelvic lesions and metastatic tumors may be pathological examination should pay attention to mesothelioma and metastatic adenocarcinoma and the source of epithelial ovarian tumors to distinguish the differential difficulties should be made by immunohistochemistry or electron microscopy examination
3. Other primary malignant tumors in the peritoneal peritoneal serous borderline tumors also known as atypical tubal endometriosis of primary peritoneal papillary tumors and low-grade peritoneal serous small papillomatosis is a rare primary in the peritoneal lesions often occur in women of any age may be involved in most patients under the age of 40 main symptoms are abdominal or pelvic pain symptoms of chronic pelvic inflammatory disease and even pathological phenomena of adhesion, or amenorrhea, can be made with peritoneal mesothelioma the differential diagnosis of this disease a better prognosis
Other primary tumors in the peritoneal adenocarcinoma fibrosarcoma liposarcoma is very rare and so hard to reconcile with the clinical distinction between peritoneal mesothelioma are mostly found in the autopsy
Tuesday, December 1, 2009
Peritoneal mesothelioma check what should be done?
1. Blood tests of patients with peritoneal mesothelioma may have thrombocytosis low blood sugar increased fibrin degradation products and high immunoglobulin hyperlipidemia in patients with peritoneal mesothelioma, about 25% of patients so that the part of the CA125 elevated Duan mesothelial cell-derived tumors have the ability to secrete CA125 at the same time if the patient has peritoneal mesothelioma, intrahepatic metastasis of liver with chronic liver disease caused by the scavenging capacity of CA125 decline in the serum CA125 level may be significantly increased due to increased CA125 is also more common in ovarian cancer can be found in pancreatic cancer Therefore, gastric cancer and breast cancer serum CA125 determination in the differential diagnosis of peritoneal mesothelioma is not
2. Ascites ascites examination of peritoneal mesothelioma can bloody or yellow exudate cells due to mesothelioma, an active function of the secretion of hyaluronic acid in the hyaluronic acid concentration in serosal effusions of up to 0.2 ~ 0.8g / L (turbidity test) although the infection and heart failure caused by metastatic tumors in serous effusion may also be increased but the hyaluronic acid concentration is greater than 0.8g / L were seen only in malignant mesothelioma, hyaluronic acid content, therefore ascites Determination of the diagnosis of peritoneal mesothelioma, mesothelioma, an organization of reference value due to the lack of carcinoembryonic antigen (CEA), such as CEA in ascites were higher than 10 ~ 15μg / L right to exclude the diagnosis of malignant mesothelioma of some significance also was found : mesothelioma patients with ascites increased levels of acid mucopolysaccharide mesothelioma cells with anti-serum can be detected in serous exudate ascites addition, the corresponding antigen human chorionic gonadotropin (HCG) increased levels of plasma HCG levels normal help to distinguish benign and malignant peritoneal mesothelioma in the collagen level of ascites can help to distinguish between the presence of lesions of mesothelioma or metastatic adenocarcinoma
Ascites cytology has certain clinical value reported in the literature at home and abroad ascites in patients with peritoneal mesothelioma often can not find the typical mesothelioma cells, ascites, if found in a large number of special-shaped or atypical mesothelial cells or tumor cells can be Analysis of measured nuclear area ratio of cytoplasmic area and nuclear plasma parameters, such as combination of electron microscopy and immunohistochemistry with the proliferation of check to mesothelial cells and metastatic adenocarcinoma, sarcoma, and other identification
1. Gastrointestinal tract gastrointestinal tract contrast imaging have the following performance:
(1) The shift to change the compression bowels twisted bowel loop shape is not the whole distance widened
(2) The abnormal distribution bowels crowded around the tumor margin of the distribution of weeks
(3) If the intestine caused by tumor compression severe stenosis can be expressed as incomplete intestinal obstruction
(4) late aggregation adhesion can occur bowels regular and intact mucosal folds but the performance of both the above-mentioned non-specific prompts the disease can only be indirectly
2. Abdominal ultrasound ascites due to peritoneal mesothelioma often accompanied by production of ascites in the ultrasound observation of peritoneal provide a good acoustic conditions for a long time can clearly observe the ascites into the peritoneal site of its new size and shape echoes the common ultrasonic peritoneal mesothelioma like the diagram has the following characteristics:
(1), irregular thickening of part of the peritoneum was much more substantial part of the mass change in shape was irregular lobulated
(2) may be associated with ascites after retroperitoneal lymph nodes or other organs of the transfer of audio-visual
(3) accompanied by thickening of greater omentum and mesentery of the bowel caused by the pushing pressure of incomplete intestinal obstruction, and changes in intestinal adhesion
(4) line of color Doppler ultrasound lumps around and see the rich blood flow within the ultrasound examination the diagnosis of peritoneal mesothelioma have a certain value of ultrasound-guided biopsy of the pathological diagnosis of the exact available
3.CT scan CT scan diagnosis of peritoneal mesothelioma peritoneal mesothelioma must help ascites is the most common CT manifestations; Early CT showed peritoneal lesions more difficult; as a wide range of peritoneal adhesions greater omentum and mesentery can be seen when the CT under the wide range of irregular thickening of the omentum of the peritoneal adhesion formation involved Pie mesenteric abdominal mass density increased adhesion formation, or wrinkled paper flowers star-shaped mass in the performance characteristics of CT is not easy, but the gastrointestinal tract and ovarian cancer and peritoneal metastasis identification of chronic infections CT periodically review the progress and efficacy of the lesions observed are very useful
Number of other instruments such as imaging studies such as celiac artery angiography MRI can be used for the diagnosis of peritoneal mesothelioma, but because of their trauma or expensive than commonly used in clinical
4. Laparoscopy Laparoscopy is a simple and effective means of diagnosis of malignant peritoneal mesothelioma microscope parietal and visceral peritoneum omentum diffuse distribution of hepatic tumor nodules plaque fibrous capsule (Glisson's capsule) There may also have nodules, but the performance of liver parenchyma without invasion; endoscopic intra-abdominal non-metastatic liver cancer or other pelvic organs, microscopic evidence of tumor can be parietal and visceral peritoneum and omentum lesions and lesions at relatively normal organization at the junction of multiple biopsy forceps with a larger organization can be satisfactory for the pathological examination Laparoscopy can exclude other organs within the abdominal or pelvic tumor and disease microscopy without any complications, but a large number of intra-abdominal ascites broad and organs within the lesion marked by laparoscopic examination of adhesion subject to certain restrictions
B-ultrasonography and CT examination can be found in a thin sheet of images and ascites ascites tumor exudate can also be as bloody ascites in hyaluronic acid, such as increased to 120ug/ml helpful in the diagnosis of ascites to find new biological mesothelioma cells with a diagnosis of ascites can also be the middle of the skin cell chromosome analysis assist in diagnosis of laparoscopies, visible peritoneal surface nodules and plaques covered with pathological examination confirm the diagnosis of biopsy
2. Ascites ascites examination of peritoneal mesothelioma can bloody or yellow exudate cells due to mesothelioma, an active function of the secretion of hyaluronic acid in the hyaluronic acid concentration in serosal effusions of up to 0.2 ~ 0.8g / L (turbidity test) although the infection and heart failure caused by metastatic tumors in serous effusion may also be increased but the hyaluronic acid concentration is greater than 0.8g / L were seen only in malignant mesothelioma, hyaluronic acid content, therefore ascites Determination of the diagnosis of peritoneal mesothelioma, mesothelioma, an organization of reference value due to the lack of carcinoembryonic antigen (CEA), such as CEA in ascites were higher than 10 ~ 15μg / L right to exclude the diagnosis of malignant mesothelioma of some significance also was found : mesothelioma patients with ascites increased levels of acid mucopolysaccharide mesothelioma cells with anti-serum can be detected in serous exudate ascites addition, the corresponding antigen human chorionic gonadotropin (HCG) increased levels of plasma HCG levels normal help to distinguish benign and malignant peritoneal mesothelioma in the collagen level of ascites can help to distinguish between the presence of lesions of mesothelioma or metastatic adenocarcinoma
Ascites cytology has certain clinical value reported in the literature at home and abroad ascites in patients with peritoneal mesothelioma often can not find the typical mesothelioma cells, ascites, if found in a large number of special-shaped or atypical mesothelial cells or tumor cells can be Analysis of measured nuclear area ratio of cytoplasmic area and nuclear plasma parameters, such as combination of electron microscopy and immunohistochemistry with the proliferation of check to mesothelial cells and metastatic adenocarcinoma, sarcoma, and other identification
1. Gastrointestinal tract gastrointestinal tract contrast imaging have the following performance:
(1) The shift to change the compression bowels twisted bowel loop shape is not the whole distance widened
(2) The abnormal distribution bowels crowded around the tumor margin of the distribution of weeks
(3) If the intestine caused by tumor compression severe stenosis can be expressed as incomplete intestinal obstruction
(4) late aggregation adhesion can occur bowels regular and intact mucosal folds but the performance of both the above-mentioned non-specific prompts the disease can only be indirectly
2. Abdominal ultrasound ascites due to peritoneal mesothelioma often accompanied by production of ascites in the ultrasound observation of peritoneal provide a good acoustic conditions for a long time can clearly observe the ascites into the peritoneal site of its new size and shape echoes the common ultrasonic peritoneal mesothelioma like the diagram has the following characteristics:
(1), irregular thickening of part of the peritoneum was much more substantial part of the mass change in shape was irregular lobulated
(2) may be associated with ascites after retroperitoneal lymph nodes or other organs of the transfer of audio-visual
(3) accompanied by thickening of greater omentum and mesentery of the bowel caused by the pushing pressure of incomplete intestinal obstruction, and changes in intestinal adhesion
(4) line of color Doppler ultrasound lumps around and see the rich blood flow within the ultrasound examination the diagnosis of peritoneal mesothelioma have a certain value of ultrasound-guided biopsy of the pathological diagnosis of the exact available
3.CT scan CT scan diagnosis of peritoneal mesothelioma peritoneal mesothelioma must help ascites is the most common CT manifestations; Early CT showed peritoneal lesions more difficult; as a wide range of peritoneal adhesions greater omentum and mesentery can be seen when the CT under the wide range of irregular thickening of the omentum of the peritoneal adhesion formation involved Pie mesenteric abdominal mass density increased adhesion formation, or wrinkled paper flowers star-shaped mass in the performance characteristics of CT is not easy, but the gastrointestinal tract and ovarian cancer and peritoneal metastasis identification of chronic infections CT periodically review the progress and efficacy of the lesions observed are very useful
Number of other instruments such as imaging studies such as celiac artery angiography MRI can be used for the diagnosis of peritoneal mesothelioma, but because of their trauma or expensive than commonly used in clinical
4. Laparoscopy Laparoscopy is a simple and effective means of diagnosis of malignant peritoneal mesothelioma microscope parietal and visceral peritoneum omentum diffuse distribution of hepatic tumor nodules plaque fibrous capsule (Glisson's capsule) There may also have nodules, but the performance of liver parenchyma without invasion; endoscopic intra-abdominal non-metastatic liver cancer or other pelvic organs, microscopic evidence of tumor can be parietal and visceral peritoneum and omentum lesions and lesions at relatively normal organization at the junction of multiple biopsy forceps with a larger organization can be satisfactory for the pathological examination Laparoscopy can exclude other organs within the abdominal or pelvic tumor and disease microscopy without any complications, but a large number of intra-abdominal ascites broad and organs within the lesion marked by laparoscopic examination of adhesion subject to certain restrictions
B-ultrasonography and CT examination can be found in a thin sheet of images and ascites ascites tumor exudate can also be as bloody ascites in hyaluronic acid, such as increased to 120ug/ml helpful in the diagnosis of ascites to find new biological mesothelioma cells with a diagnosis of ascites can also be the middle of the skin cell chromosome analysis assist in diagnosis of laparoscopies, visible peritoneal surface nodules and plaques covered with pathological examination confirm the diagnosis of biopsy
Monday, November 30, 2009
What are the performance of peritoneal mesothelioma and how to diagnose?
Peritoneal mesothelioma can occur in 2 to 92 years of age reported in the literature abroad, and their average age was 54 years old diagnosed with about 63% of the cases are between the ages of 45 to 64 sick children, a rare tumor of early peritoneal mesothelial cells no obvious symptoms of only the tumor grow to a certain size and involving the gastrointestinal and other abdominal viscera before clinical symptoms appear mainly as abdominal pain, abdominal distension with ascites of gastrointestinal symptoms and body mass changes in
1. Peritoneal mesothelioma, abdominal pain, abdominal pain is the most common symptoms of persistent pain can also be as paroxysmal pain cramps or sudden pain and often pain in the upper abdomen and right upper quadrant abdominal Department also has abdominal pain caused by the following clinical misdiagnosed as ectopic pregnancy or pelvic tumors reported the occurrence of abdominal pain and violations of tumor and the parietal peritoneum and pelvic organs of the gastrointestinal tract obstruction caused by adhesions and a large number of organs to reverse ascites abdominal mass produce mass effect and other factors related to the nature and duration of abdominal pain in site can be changed
2. Bloating due to intra-abdominal mass and ascites secondary to dyspepsia patients with intestinal obstruction and other factors may have varying degrees of abdominal distention severe symptoms that can affect eating or even difficulty in breathing
3. Ascites about 90% of patients with peritoneal mesothelioma there is a considerable portion of patients with ascites and ascites for the rapid growth of ascites fluid or bloody yellow viscous liquid in this leakage and tumor cells with active secretion of hyaluronic acid function of the
4. Peritoneal mesothelioma, abdominal mass is a common clinical manifestations of some patients is due to abdominal mass and treatment of peritoneal mesothelioma abdominal mass may be a single hair can also be made for multi-texture of the surface was more rigid or hard nodules like in the mesenteric serosal surface of the greater omentum mass in the physical examination can be moved abdominal mass may have tenderness in the pelvic mass by digital rectal examination or a triple merger consultation found a large number of patients with ascites after ascites drainage can be more a clear understanding of the detailed medical examination of abdominal mass may be a preliminary understanding of abdominal mass in the abdominal organs in addition to the substantive provision of first consultation for clinical information
5. Other minority patients may also have nausea, vomiting, diarrhea, loss of appetite occurs or constipation, urinary tract irritation menstrual changes and weight loss fatigue fever anemia patients have low blood sugar for individual diffuse abdominal ossification of clinical manifestations such as when a patient associated with other parts of mesothelioma or peritoneal mesothelioma metastasis to other organs or complications can occur when the corresponding clinical manifestations of
Reported in the literature very few patients with pleural mesothelioma exist, or other parts of the peritoneal mesothelioma peritoneal mesothelioma mesothelioma and other parts of the place or for multi-center, or for the primary tumor and metastasis is still not very clear about the relationship between the
A large number of autopsy material that not only can directly Baptist peritoneal mesothelioma and abdominal pelvic organ distant metastasis of peritoneal mesothelioma can also be caused by direct invasion and gastrointestinal tract of patients in which direct invasion of tumor cells may be as deep as the submucosa or mucosa peritoneal mesothelioma can also invade the gallbladder to the abdominal parenchymal organs such as pancreas, prostate, and bladder cancer can also be transferred to the lymph nodes and liver heart lung kidney bone marrow and other tissues and organs of adrenal
As the gastrointestinal tract and gastrointestinal tumors extrusion adhesion and invasion of peritoneal mesothelioma and gastrointestinal wall can cause intestinal obstruction
As the onset of misprision of peritoneal mesothelioma does not have specific clinical manifestations related to supporting the positive rate is not high specificity is not strong so its very difficult for the early diagnosis of cases reported in the literature, or even more than by laparotomy surgery due to other diseases (such as hernia repair surgery), the biopsy was confirmed with the B-ultrasound and CT laparoscopy-guided biopsy technology, to carry out, as well as pathology immunohistochemistry and electron microscopy diagnosis of raising the level of a growing number of cases in his lifetime as well as clearly pathological preoperative Diagnosis
Clinically unexplained abdominal pain and distention of the ascites and abdominal mass of patients, especially when a patient with asbestos exposure history should be considered when the diagnosis of peritoneal mesothelioma, and repeated ascites cytology and related inspections, such as abdominal CT examination revealed a typical related to changes in other parts of the examination has failed to find evidence of a primary tumor should be highly suspected diagnosis of peritoneal mesothelioma by laparoscopic examination and pathological examination confirmed the need to consider exploratory laparotomy diagnosis and to seek surgical treatment at the same time
Because ascites cytology and biopsy specimens stained less ordinary optical microscope pathological diagnosis is sometimes difficult immunohistochemical staining electron microscopy help to diagnosis
In making the diagnosis of peritoneal mesothelioma at the same time deal with some understanding of their stage of disease early or late stage of disease prognosis in the selection of treatment decisions of great significance in 1976 and other proposed changes Butchart phased program will be divided into four mesothelioma Phase Ⅰ: tumor confined to ipsilateral pleuropulmonary, pericardial or peritoneal; Ⅱ period: mediastinal tumors invading the chest wall and (or) the chest or abdominal lymph nodes the corresponding structure; Ⅲ period: outer membrane penetration diaphragm abdominal lymph node involvement; Ⅳ period: Yuan Department of hematogenous metastasis, some scholars have differences of opinion still exist in the program and therefore need to be further improved
1. Peritoneal mesothelioma, abdominal pain, abdominal pain is the most common symptoms of persistent pain can also be as paroxysmal pain cramps or sudden pain and often pain in the upper abdomen and right upper quadrant abdominal Department also has abdominal pain caused by the following clinical misdiagnosed as ectopic pregnancy or pelvic tumors reported the occurrence of abdominal pain and violations of tumor and the parietal peritoneum and pelvic organs of the gastrointestinal tract obstruction caused by adhesions and a large number of organs to reverse ascites abdominal mass produce mass effect and other factors related to the nature and duration of abdominal pain in site can be changed
2. Bloating due to intra-abdominal mass and ascites secondary to dyspepsia patients with intestinal obstruction and other factors may have varying degrees of abdominal distention severe symptoms that can affect eating or even difficulty in breathing
3. Ascites about 90% of patients with peritoneal mesothelioma there is a considerable portion of patients with ascites and ascites for the rapid growth of ascites fluid or bloody yellow viscous liquid in this leakage and tumor cells with active secretion of hyaluronic acid function of the
4. Peritoneal mesothelioma, abdominal mass is a common clinical manifestations of some patients is due to abdominal mass and treatment of peritoneal mesothelioma abdominal mass may be a single hair can also be made for multi-texture of the surface was more rigid or hard nodules like in the mesenteric serosal surface of the greater omentum mass in the physical examination can be moved abdominal mass may have tenderness in the pelvic mass by digital rectal examination or a triple merger consultation found a large number of patients with ascites after ascites drainage can be more a clear understanding of the detailed medical examination of abdominal mass may be a preliminary understanding of abdominal mass in the abdominal organs in addition to the substantive provision of first consultation for clinical information
5. Other minority patients may also have nausea, vomiting, diarrhea, loss of appetite occurs or constipation, urinary tract irritation menstrual changes and weight loss fatigue fever anemia patients have low blood sugar for individual diffuse abdominal ossification of clinical manifestations such as when a patient associated with other parts of mesothelioma or peritoneal mesothelioma metastasis to other organs or complications can occur when the corresponding clinical manifestations of
Reported in the literature very few patients with pleural mesothelioma exist, or other parts of the peritoneal mesothelioma peritoneal mesothelioma mesothelioma and other parts of the place or for multi-center, or for the primary tumor and metastasis is still not very clear about the relationship between the
A large number of autopsy material that not only can directly Baptist peritoneal mesothelioma and abdominal pelvic organ distant metastasis of peritoneal mesothelioma can also be caused by direct invasion and gastrointestinal tract of patients in which direct invasion of tumor cells may be as deep as the submucosa or mucosa peritoneal mesothelioma can also invade the gallbladder to the abdominal parenchymal organs such as pancreas, prostate, and bladder cancer can also be transferred to the lymph nodes and liver heart lung kidney bone marrow and other tissues and organs of adrenal
As the gastrointestinal tract and gastrointestinal tumors extrusion adhesion and invasion of peritoneal mesothelioma and gastrointestinal wall can cause intestinal obstruction
As the onset of misprision of peritoneal mesothelioma does not have specific clinical manifestations related to supporting the positive rate is not high specificity is not strong so its very difficult for the early diagnosis of cases reported in the literature, or even more than by laparotomy surgery due to other diseases (such as hernia repair surgery), the biopsy was confirmed with the B-ultrasound and CT laparoscopy-guided biopsy technology, to carry out, as well as pathology immunohistochemistry and electron microscopy diagnosis of raising the level of a growing number of cases in his lifetime as well as clearly pathological preoperative Diagnosis
Clinically unexplained abdominal pain and distention of the ascites and abdominal mass of patients, especially when a patient with asbestos exposure history should be considered when the diagnosis of peritoneal mesothelioma, and repeated ascites cytology and related inspections, such as abdominal CT examination revealed a typical related to changes in other parts of the examination has failed to find evidence of a primary tumor should be highly suspected diagnosis of peritoneal mesothelioma by laparoscopic examination and pathological examination confirmed the need to consider exploratory laparotomy diagnosis and to seek surgical treatment at the same time
Because ascites cytology and biopsy specimens stained less ordinary optical microscope pathological diagnosis is sometimes difficult immunohistochemical staining electron microscopy help to diagnosis
In making the diagnosis of peritoneal mesothelioma at the same time deal with some understanding of their stage of disease early or late stage of disease prognosis in the selection of treatment decisions of great significance in 1976 and other proposed changes Butchart phased program will be divided into four mesothelioma Phase Ⅰ: tumor confined to ipsilateral pleuropulmonary, pericardial or peritoneal; Ⅱ period: mediastinal tumors invading the chest wall and (or) the chest or abdominal lymph nodes the corresponding structure; Ⅲ period: outer membrane penetration diaphragm abdominal lymph node involvement; Ⅳ period: Yuan Department of hematogenous metastasis, some scholars have differences of opinion still exist in the program and therefore need to be further improved
Friday, November 27, 2009
What is the peritoneum mesothelioma the cause?
(A) causes of morbidity
The etiology and pathogenesis of asbestos exposure and contacts on its very long intervals often more than 30 years as early as 40 years in the 20th century, foreign scholars have discovered that the occurrence of mesothelioma and asbestos exposure close to the shipyard workers, pipeline workers, construction workers, welders and paint the incidence of 300 times more than the average height of a man close relationship between mesothelioma and asbestos exposure has been more and more confirmed by the fact that at the same time Europe and the United States with recognized scholars found that about 60% of peritoneal mesothelioma patients have occupational asbestos exposure history or lung tissue There are asbestos bodies in the use of asbestos-induced pleural mesothelioma in experimental animals is also a small number of animals, peritoneal mesothelioma, peritoneal mesothelioma, note the occurrence and the relationship between asbestos exposure has some different types of asbestos fibers in turn pathogenic risk as follows: crocidolite "amosite" chrysotile is generally believed that a long diameter of 0.5 ~ 50μm asbestos dust first and then through the diaphragm into the respiratory lymphoid tissue or blood into the abdominal cavity and the net deposition of the formation of asbestos bodies in the peritoneal asbestos bodies sometimes can occur around foreign body giant cell reaction to ingestion of asbestos fibers through the digestive tract can also be reached through the intestinal wall and peritoneal mesothelioma from exposure to asbestos have been detected an average of 35 ~ 40 years of peak incidence 45 years after exposure to asbestos-caused mesothelioma, the exact mechanism is not very clear but about 30% of mesothelioma patients with no history of exposure to asbestos fibers and asbestos quantitative examinations found no contact with a large number of asbestos fibers with the performance reported in the literature related to the occurrence of mesothelioma and other factors are history of exposure to radiation therapy thorium dioxide, (usually related to patients receiving diagnostic history) also occurs in patients with a history of Hodgkin increase the risk of mesothelioma
Infection: simian virus (simian virus 40SV40) It is a DNA tumor virus, according to the United States reported in the literature about 50% of the biopsy specimens of patients with mesothelioma it is present in SV40-induced telomerase activity in primary mesothelioma, but does not affect the fibroblasts 72h after infection of wild-type SV40 can be measured telomerase activity after 1 week shows a clear structure of DNA in the cell tower ladder of telomerase activity and SV40 T antigen is directly proportional to the number of SV40 infected mesothelial cells, the telomere enzyme activity is not easy to increase apoptosis of mesothelial cells allows the formation of mesothelioma, easily understood
Mesothelioma also may be related to the following factors: exposure Fluorspar scars of chronic inflammation of tuberculosis genetic susceptibility and other radioactive substances
(B) the pathogenesis of
According to their biological behavior and tumor invasion and scope can be divided into benign and malignant mesothelioma limitations and diffuse mesothelioma cases in the large coverage of about 57.1% occurred in the pleura 39.5%, occurred in the peritoneum can be 1% occurred in the pericardial involving multiple serosal surface or even in the testis sheath
1. Mesothelioma earlier that the genetic organization of two kinds of cells from the surface of the peritoneal mesothelial cells and connective tissue cells, has recently been confirmed to be from a single cell that the mesothelial cells of mesothelial cells to epithelial cells and fiber cells were two kinds of morphological differentiation Dardick (1984) found in sarcomatoid mesothelioma in the region does not show ultrastructural characteristics of fibroblasts display different stages of differentiation characteristics of epithelial cells using immunohistochemical methods Blobel prove cytokeratin polypeptide ( cytokeratin polypeptide) in the fibrous mesothelioma, and the expression of epithelial mesothelioma are wavy fibrin (fibrin) in the same or the same tumor cells also express the two-way display Expression of mesothelioma
2. Peritoneal mesothelioma can be divided into low-grade malignant cystic well-differentiated papillary mesothelioma, mesothelioma and malignant mesothelioma
(1) low-grade cystic mesothelioma: is common in middle-aged women, often located within the pelvic extraperitoneal tumors can invade and more often ill-defined capsule was not obvious in the structure of the surrounding pelvic adhesions aspect for multi-cystic wall smooth capsule containing clear liquid or thin mucous cyst lining flat to low columnar mesothelial cells can be shaped with mild to moderate papillary hyperplasia and metaplasia cyst showed fibrous stromal hyperplasia in which no significant chronic inflammatory cell infiltration
(2) well-differentiated papillary mesothelioma: surgery is not commonly found even in women of childbearing age occur in the general principles of good prognosis for malignant mesothelioma can develop even visible pelvic peritoneum and omentum showed multiple papillary or nodular off-white solid lesion diameter <2cm tumor may also occur in the peritoneum and mesenteric gastrointestinal endoscopic papillary tumor coating the surface of single-storey flat to cuboidal mesothelial cells, rare mitotic nucleus is no different-type cytoplasm axis of fibrous stromal tumors can be seen from the mesothelial cells formed branching tubule-like cord or a piece of solid block occasionally psammoma body
(3) malignant mesothelioma: The tumor was single or multiple dispersed growth at the same time involving the visceral and parietal peritoneum can be classified according to shape and limitations of diffuse-type localized malignant mesothelioma, a clear boundary or envelope was hard and tough pedicle low level of diffuse malignant mesothelioma, malignant peritoneal involvement showed diffuse thickening of the surface of papillary plaque or nodular in general have seen a high degree of malignant peritoneal surface are widely distributed, ranging from the size of the tumor nodules in isolation like strings of beads or was cluster-like clumps from a few millimeters to a few centimeters in diameter was yellow-white or off-white hard like rubber-like material was significantly thicker than the late peritoneal peritoneal tumor tissue was covered by dense white so that organ into a "frozen" (frozen) state of tumor organizations and the abdominal viscera, especially the digestive tract sticky fused with each other easily separated or in the peritoneal surface of abdominal organ with multiple nodular tumor was found in grape-like or diffuse peritoneal surface of diaphragm abdominal peritoneal surface and omentum after the small intestine and mesenteric colon serosal bladder surface or the liver surface and sometimes multiple nodules fused into lumps
Peritoneal mesothelial cell tumor of the general pathological view of human peritoneal mesothelial cell tumor of the general observation is similar to pleural mesothelioma, there are two kinds of types that diffuse peritoneal mesothelial cell tumor and limitations of peritoneal mesothelial cell tumor of general diffuse mesothelioma 75% of malignant mesothelioma of the limitations of the former are mostly benign tumor tissue showed numerous small nodules or plaques on the lining of the parietal or visceral peritoneal tumor development with massive thickening of the films showed a wide range blanket in the parietal peritoneal, or abdominal organs may be associated with the surface of tumor or nodules of varying sizes Duocheng off-white tumor tissue was hard and tough can also have bleeding and necrosis of jelly tumor tissue fibrosis and even glass-like tumor tissue can be changed invasive liver or intestine but rarely invade deep organs in the greater omentum can be completely replaced by tumor tissue intestinal adhesions can occur within the abdominal cavity exudate and even the limitations of bloody ascites in the peritoneal mesothelial cell tumor or nodular tumor tissue showed plaque is located in visceral peritoneal lining, or off-white material was clearly very few hard limits bleeding and necrosis (Figure 1)
3. Peritoneal mesothelial cell tumor of microscopic observation peritoneal mesothelial cells are generally three kinds of tumor histological type:
(1) fibrous mesothelioma: fibrous mesothelioma tumor cells from the elongated spindle cells, spindle cells accompanied by the number of collagen fibers, ranging from the limitations of this type more common in mesothelioma, fibrous mesothelioma in and fibrous tissue is sometimes difficult to distinguish tumor cells were spindle-shaped cells around the tumor may have or may have weave of collagen-like structure of focal calcification or ossification obvious when interstitial fibrosis or hyalinization, when some people call them Desmoid mesothelioma Recently, there were will come from the subcutaneous connective tissue between the source of fibroid tumors is called peritoneal mesothelial cells from the surface, said fibrous mesothelioma was based solely on morphology, but is sometimes difficult to distinguish between the two years (Figure 2)
(2) epithelioid mesothelioma: epithelioid mesothelioma is cube-shaped or polygonal tumor cells often have veins tubular or papillary structures found in most epithelial mesothelioma, diffuse mesothelioma, in the differentiation of tumor cells was different from the state can form well-differentiated tubular or papillary structures can also be presented on-chip block undifferentiated tumor showed solid tumor cells of different sizes of the connective tissue surrounding the tumor tissue of tubular papillary structure or composition of adenoid cystic tubular lining by cubic or flat epithelial-like cells of the same size vacuole nucleus can be seen 1 to 2 nucleoli outline a clear cytoplasm rich in tumor cells, slit-like or form can also be presented, ranging from the size of cysts lined with flat epithelial cells of these Sometimes fissures can be seen within the papillary adenocarcinoma papillary protrusions similar to some cases of solid tumor cells arranged in cord-like or nested structure without adenoid or papillary tumor tissue but sometimes the material surrounding the formation of mucus may have a similar structure of mucus cell morphology in Lake more consistent when the nuclear large and small cytoplasm vacuolization containing mucopolysaccharide material (Figure 3)
(3) mixed mesothelioma: mesothelioma, also known as bi-directional differentiation of the tumor accompanied by the same two kinds of fibers and epithelial components Zllzllki (1980) reported 210 cases of diffuse malignant mesothelioma, epithelioid in 67% 26% mixed fibers accounted for 7 percent of the latter is most common in the limitations of mesothelioma, mesothelioma tumor tissue within the hybrid cells and by epithelial-like morphology similar to the sarcoma-like ingredients synovial sarcoma spindle cell sarcoma-like component formed by the It is often transitional form with the epithelial component and thus can be displayed mesothelioma is a cell from a single source of asbestos-related mesothelioma, we often see this form of mucin stain in differentiating between adenocarcinoma and mesothelioma help but differentiated adenocarcinoma low mucus staining can also be negative and mesothelioma tumor cells can also show positive staining Alcianblue and such mucus can also be found in the extracellular interstitial reticular fiber staining in the tumor cells can be seen between the rich reticular fiber distinct adenocarcinoma helpful when the tumor was found asbestos bodies (asbestosbody) be helpful when the diagnosis of mesothelioma is pleural mesothelioma, in particular due to asbestos and the occurrence of adenocarcinoma of the lung and therefore also the relationship between asbestos bodies found in only a reference value ( Figure 4)
4. Peritoneal mesothelial cell tumor ultrastructure and electron microscopy, especially transmission electron microscopy in the diagnosis of mesothelial tumors have a high value of their ultrastructure is characterized by: mesothelioma tumor cells have a large number of thin brush kind of Microvilli appear on the surface of tumor cells but it can also appear in the cytoplasm, but in adenocarcinoma of the small number of short rod-like microvilli of mesothelioma cells has a huge nuclei prominent nucleoli moderate amount of mitochondria has been rough endoplasmic Net glycogen granules into the surrounding common beam tonofilaments and intracellular vacuole smooth endoplasmic reticulum is not well developed extracellular substrates but most do not have a complete connection can also be found between cells with ultrastructural features of these major desmosome found in epithelial cells or mixed mesothelioma mesothelioma mesothelioma in the fibrous ultrastructure similar to the fibroblast cells in the spindle tumor cells have abundant rough endoplasmic reticulum occasionally a tiny cavity between cells gap as well as the microvilli (Figure 5)
5. Peritoneal mesothelial cell tumors by immunohistochemistry Immunohistochemical differential diagnosis of mesothelioma and adenocarcinoma of definite help cytokeratin (cytokeratin) showed positive in mesothelioma, but CEA was negative or weakly positive; adenocarcinoma CEA mostly strong positive and keratin (keratin) often as a focal positive or negative, but due to various reasons in the literature for the immunohistochemical staining in differentiating mesothelioma and adenocarcinoma of the reports have different results and so therefore can not simply make a final conclusion must be Integrated other technologies to make an objective diagnosis of certain mesothelioma patients associated with metabolic disorders such as reducing blood sugar disorders such limitations occasionally peritoneal mesothelial cells showed multi-cystic tumor can be lined with simple cuboidal or squamous epithelial capsule containing a transparent liquid
Mesothelioma cells, electron microscopy and enzyme histochemical features: mesothelioma mainly by the epithelial-like cells (epithelioid cellEC) fibroblast-like cells (fibroblast-like cellFLC) intermediate cell (interim cellIC) and primitive mesenchymal cells (primary mesenchymal cellPMC ) EC to four kinds of cells characterized by abundant microvilli on cell surface microvilli on their long slender diameter and width and the ratio reached 10:1 ~ 15:1 This is far greater than the proportion of adenocarcinoma of several other tumor cell showed sinus-like gap around the inside of its slender microvilli, there are many intertwined FLC in the rough endoplasmic reticulum are more EC dehydrogenase and oxidase activity in higher and lower hydrolytic activity of the FLC cell activity and the EC On the contrary it may be related to functional activity of the two types of cells different from the
Mesothelioma immunohistochemical features: Since the original mesenchymal cells directly or through intermediate-type cells to epithelial-like cells can also be directly differentiated into fibrous mesothelioma of the immune cells, thus staining the complex types of mesothelial immunohistochemical features of tumor cells, such as in Table 1
As can be seen from the table a variety of mesothelioma, the expression of immunohistochemical reaction of the variety of situations to express their positive and negative results were not 100%, therefore certain abdominal tumors, especially ovarian serous papillary cystadenocarcinoma and epithelial papillary mesothelioma of the tubular structure is difficult to identify the former on the carcinoembryonic antigen expression of only 2% of the pairs of epithelial membrane antigen and human milk fat globulin expression there is a higher percentage of it immunohistochemical staining using the above it is difficult to two are distinguished from the recent application of Ber-Ep4 antibody able to identify malignant mesothelioma and adenocarcinoma Ber-Ep4 pairs of abdominal and retroperitoneal and peritoneal adenocarcinoma metastatic adenocarcinoma of the positive expression rate of 100% while the 115 cases of mesothelioma expression of only 1 case (accounting for 0.87%), therefore the use of a comprehensive analysis of immunohistochemical staining can make a correct pathological diagnosis of mesothelioma, if the conditions are even more improved electron microscope examination
The etiology and pathogenesis of asbestos exposure and contacts on its very long intervals often more than 30 years as early as 40 years in the 20th century, foreign scholars have discovered that the occurrence of mesothelioma and asbestos exposure close to the shipyard workers, pipeline workers, construction workers, welders and paint the incidence of 300 times more than the average height of a man close relationship between mesothelioma and asbestos exposure has been more and more confirmed by the fact that at the same time Europe and the United States with recognized scholars found that about 60% of peritoneal mesothelioma patients have occupational asbestos exposure history or lung tissue There are asbestos bodies in the use of asbestos-induced pleural mesothelioma in experimental animals is also a small number of animals, peritoneal mesothelioma, peritoneal mesothelioma, note the occurrence and the relationship between asbestos exposure has some different types of asbestos fibers in turn pathogenic risk as follows: crocidolite "amosite" chrysotile is generally believed that a long diameter of 0.5 ~ 50μm asbestos dust first and then through the diaphragm into the respiratory lymphoid tissue or blood into the abdominal cavity and the net deposition of the formation of asbestos bodies in the peritoneal asbestos bodies sometimes can occur around foreign body giant cell reaction to ingestion of asbestos fibers through the digestive tract can also be reached through the intestinal wall and peritoneal mesothelioma from exposure to asbestos have been detected an average of 35 ~ 40 years of peak incidence 45 years after exposure to asbestos-caused mesothelioma, the exact mechanism is not very clear but about 30% of mesothelioma patients with no history of exposure to asbestos fibers and asbestos quantitative examinations found no contact with a large number of asbestos fibers with the performance reported in the literature related to the occurrence of mesothelioma and other factors are history of exposure to radiation therapy thorium dioxide, (usually related to patients receiving diagnostic history) also occurs in patients with a history of Hodgkin increase the risk of mesothelioma
Infection: simian virus (simian virus 40SV40) It is a DNA tumor virus, according to the United States reported in the literature about 50% of the biopsy specimens of patients with mesothelioma it is present in SV40-induced telomerase activity in primary mesothelioma, but does not affect the fibroblasts 72h after infection of wild-type SV40 can be measured telomerase activity after 1 week shows a clear structure of DNA in the cell tower ladder of telomerase activity and SV40 T antigen is directly proportional to the number of SV40 infected mesothelial cells, the telomere enzyme activity is not easy to increase apoptosis of mesothelial cells allows the formation of mesothelioma, easily understood
Mesothelioma also may be related to the following factors: exposure Fluorspar scars of chronic inflammation of tuberculosis genetic susceptibility and other radioactive substances
(B) the pathogenesis of
According to their biological behavior and tumor invasion and scope can be divided into benign and malignant mesothelioma limitations and diffuse mesothelioma cases in the large coverage of about 57.1% occurred in the pleura 39.5%, occurred in the peritoneum can be 1% occurred in the pericardial involving multiple serosal surface or even in the testis sheath
1. Mesothelioma earlier that the genetic organization of two kinds of cells from the surface of the peritoneal mesothelial cells and connective tissue cells, has recently been confirmed to be from a single cell that the mesothelial cells of mesothelial cells to epithelial cells and fiber cells were two kinds of morphological differentiation Dardick (1984) found in sarcomatoid mesothelioma in the region does not show ultrastructural characteristics of fibroblasts display different stages of differentiation characteristics of epithelial cells using immunohistochemical methods Blobel prove cytokeratin polypeptide ( cytokeratin polypeptide) in the fibrous mesothelioma, and the expression of epithelial mesothelioma are wavy fibrin (fibrin) in the same or the same tumor cells also express the two-way display Expression of mesothelioma
2. Peritoneal mesothelioma can be divided into low-grade malignant cystic well-differentiated papillary mesothelioma, mesothelioma and malignant mesothelioma
(1) low-grade cystic mesothelioma: is common in middle-aged women, often located within the pelvic extraperitoneal tumors can invade and more often ill-defined capsule was not obvious in the structure of the surrounding pelvic adhesions aspect for multi-cystic wall smooth capsule containing clear liquid or thin mucous cyst lining flat to low columnar mesothelial cells can be shaped with mild to moderate papillary hyperplasia and metaplasia cyst showed fibrous stromal hyperplasia in which no significant chronic inflammatory cell infiltration
(2) well-differentiated papillary mesothelioma: surgery is not commonly found even in women of childbearing age occur in the general principles of good prognosis for malignant mesothelioma can develop even visible pelvic peritoneum and omentum showed multiple papillary or nodular off-white solid lesion diameter <2cm tumor may also occur in the peritoneum and mesenteric gastrointestinal endoscopic papillary tumor coating the surface of single-storey flat to cuboidal mesothelial cells, rare mitotic nucleus is no different-type cytoplasm axis of fibrous stromal tumors can be seen from the mesothelial cells formed branching tubule-like cord or a piece of solid block occasionally psammoma body
(3) malignant mesothelioma: The tumor was single or multiple dispersed growth at the same time involving the visceral and parietal peritoneum can be classified according to shape and limitations of diffuse-type localized malignant mesothelioma, a clear boundary or envelope was hard and tough pedicle low level of diffuse malignant mesothelioma, malignant peritoneal involvement showed diffuse thickening of the surface of papillary plaque or nodular in general have seen a high degree of malignant peritoneal surface are widely distributed, ranging from the size of the tumor nodules in isolation like strings of beads or was cluster-like clumps from a few millimeters to a few centimeters in diameter was yellow-white or off-white hard like rubber-like material was significantly thicker than the late peritoneal peritoneal tumor tissue was covered by dense white so that organ into a "frozen" (frozen) state of tumor organizations and the abdominal viscera, especially the digestive tract sticky fused with each other easily separated or in the peritoneal surface of abdominal organ with multiple nodular tumor was found in grape-like or diffuse peritoneal surface of diaphragm abdominal peritoneal surface and omentum after the small intestine and mesenteric colon serosal bladder surface or the liver surface and sometimes multiple nodules fused into lumps
Peritoneal mesothelial cell tumor of the general pathological view of human peritoneal mesothelial cell tumor of the general observation is similar to pleural mesothelioma, there are two kinds of types that diffuse peritoneal mesothelial cell tumor and limitations of peritoneal mesothelial cell tumor of general diffuse mesothelioma 75% of malignant mesothelioma of the limitations of the former are mostly benign tumor tissue showed numerous small nodules or plaques on the lining of the parietal or visceral peritoneal tumor development with massive thickening of the films showed a wide range blanket in the parietal peritoneal, or abdominal organs may be associated with the surface of tumor or nodules of varying sizes Duocheng off-white tumor tissue was hard and tough can also have bleeding and necrosis of jelly tumor tissue fibrosis and even glass-like tumor tissue can be changed invasive liver or intestine but rarely invade deep organs in the greater omentum can be completely replaced by tumor tissue intestinal adhesions can occur within the abdominal cavity exudate and even the limitations of bloody ascites in the peritoneal mesothelial cell tumor or nodular tumor tissue showed plaque is located in visceral peritoneal lining, or off-white material was clearly very few hard limits bleeding and necrosis (Figure 1)
3. Peritoneal mesothelial cell tumor of microscopic observation peritoneal mesothelial cells are generally three kinds of tumor histological type:
(1) fibrous mesothelioma: fibrous mesothelioma tumor cells from the elongated spindle cells, spindle cells accompanied by the number of collagen fibers, ranging from the limitations of this type more common in mesothelioma, fibrous mesothelioma in and fibrous tissue is sometimes difficult to distinguish tumor cells were spindle-shaped cells around the tumor may have or may have weave of collagen-like structure of focal calcification or ossification obvious when interstitial fibrosis or hyalinization, when some people call them Desmoid mesothelioma Recently, there were will come from the subcutaneous connective tissue between the source of fibroid tumors is called peritoneal mesothelial cells from the surface, said fibrous mesothelioma was based solely on morphology, but is sometimes difficult to distinguish between the two years (Figure 2)
(2) epithelioid mesothelioma: epithelioid mesothelioma is cube-shaped or polygonal tumor cells often have veins tubular or papillary structures found in most epithelial mesothelioma, diffuse mesothelioma, in the differentiation of tumor cells was different from the state can form well-differentiated tubular or papillary structures can also be presented on-chip block undifferentiated tumor showed solid tumor cells of different sizes of the connective tissue surrounding the tumor tissue of tubular papillary structure or composition of adenoid cystic tubular lining by cubic or flat epithelial-like cells of the same size vacuole nucleus can be seen 1 to 2 nucleoli outline a clear cytoplasm rich in tumor cells, slit-like or form can also be presented, ranging from the size of cysts lined with flat epithelial cells of these Sometimes fissures can be seen within the papillary adenocarcinoma papillary protrusions similar to some cases of solid tumor cells arranged in cord-like or nested structure without adenoid or papillary tumor tissue but sometimes the material surrounding the formation of mucus may have a similar structure of mucus cell morphology in Lake more consistent when the nuclear large and small cytoplasm vacuolization containing mucopolysaccharide material (Figure 3)
(3) mixed mesothelioma: mesothelioma, also known as bi-directional differentiation of the tumor accompanied by the same two kinds of fibers and epithelial components Zllzllki (1980) reported 210 cases of diffuse malignant mesothelioma, epithelioid in 67% 26% mixed fibers accounted for 7 percent of the latter is most common in the limitations of mesothelioma, mesothelioma tumor tissue within the hybrid cells and by epithelial-like morphology similar to the sarcoma-like ingredients synovial sarcoma spindle cell sarcoma-like component formed by the It is often transitional form with the epithelial component and thus can be displayed mesothelioma is a cell from a single source of asbestos-related mesothelioma, we often see this form of mucin stain in differentiating between adenocarcinoma and mesothelioma help but differentiated adenocarcinoma low mucus staining can also be negative and mesothelioma tumor cells can also show positive staining Alcianblue and such mucus can also be found in the extracellular interstitial reticular fiber staining in the tumor cells can be seen between the rich reticular fiber distinct adenocarcinoma helpful when the tumor was found asbestos bodies (asbestosbody) be helpful when the diagnosis of mesothelioma is pleural mesothelioma, in particular due to asbestos and the occurrence of adenocarcinoma of the lung and therefore also the relationship between asbestos bodies found in only a reference value ( Figure 4)
4. Peritoneal mesothelial cell tumor ultrastructure and electron microscopy, especially transmission electron microscopy in the diagnosis of mesothelial tumors have a high value of their ultrastructure is characterized by: mesothelioma tumor cells have a large number of thin brush kind of Microvilli appear on the surface of tumor cells but it can also appear in the cytoplasm, but in adenocarcinoma of the small number of short rod-like microvilli of mesothelioma cells has a huge nuclei prominent nucleoli moderate amount of mitochondria has been rough endoplasmic Net glycogen granules into the surrounding common beam tonofilaments and intracellular vacuole smooth endoplasmic reticulum is not well developed extracellular substrates but most do not have a complete connection can also be found between cells with ultrastructural features of these major desmosome found in epithelial cells or mixed mesothelioma mesothelioma mesothelioma in the fibrous ultrastructure similar to the fibroblast cells in the spindle tumor cells have abundant rough endoplasmic reticulum occasionally a tiny cavity between cells gap as well as the microvilli (Figure 5)
5. Peritoneal mesothelial cell tumors by immunohistochemistry Immunohistochemical differential diagnosis of mesothelioma and adenocarcinoma of definite help cytokeratin (cytokeratin) showed positive in mesothelioma, but CEA was negative or weakly positive; adenocarcinoma CEA mostly strong positive and keratin (keratin) often as a focal positive or negative, but due to various reasons in the literature for the immunohistochemical staining in differentiating mesothelioma and adenocarcinoma of the reports have different results and so therefore can not simply make a final conclusion must be Integrated other technologies to make an objective diagnosis of certain mesothelioma patients associated with metabolic disorders such as reducing blood sugar disorders such limitations occasionally peritoneal mesothelial cells showed multi-cystic tumor can be lined with simple cuboidal or squamous epithelial capsule containing a transparent liquid
Mesothelioma cells, electron microscopy and enzyme histochemical features: mesothelioma mainly by the epithelial-like cells (epithelioid cellEC) fibroblast-like cells (fibroblast-like cellFLC) intermediate cell (interim cellIC) and primitive mesenchymal cells (primary mesenchymal cellPMC ) EC to four kinds of cells characterized by abundant microvilli on cell surface microvilli on their long slender diameter and width and the ratio reached 10:1 ~ 15:1 This is far greater than the proportion of adenocarcinoma of several other tumor cell showed sinus-like gap around the inside of its slender microvilli, there are many intertwined FLC in the rough endoplasmic reticulum are more EC dehydrogenase and oxidase activity in higher and lower hydrolytic activity of the FLC cell activity and the EC On the contrary it may be related to functional activity of the two types of cells different from the
Mesothelioma immunohistochemical features: Since the original mesenchymal cells directly or through intermediate-type cells to epithelial-like cells can also be directly differentiated into fibrous mesothelioma of the immune cells, thus staining the complex types of mesothelial immunohistochemical features of tumor cells, such as in Table 1
As can be seen from the table a variety of mesothelioma, the expression of immunohistochemical reaction of the variety of situations to express their positive and negative results were not 100%, therefore certain abdominal tumors, especially ovarian serous papillary cystadenocarcinoma and epithelial papillary mesothelioma of the tubular structure is difficult to identify the former on the carcinoembryonic antigen expression of only 2% of the pairs of epithelial membrane antigen and human milk fat globulin expression there is a higher percentage of it immunohistochemical staining using the above it is difficult to two are distinguished from the recent application of Ber-Ep4 antibody able to identify malignant mesothelioma and adenocarcinoma Ber-Ep4 pairs of abdominal and retroperitoneal and peritoneal adenocarcinoma metastatic adenocarcinoma of the positive expression rate of 100% while the 115 cases of mesothelioma expression of only 1 case (accounting for 0.87%), therefore the use of a comprehensive analysis of immunohistochemical staining can make a correct pathological diagnosis of mesothelioma, if the conditions are even more improved electron microscope examination
Subscribe to:
Posts (Atom)