Malignant Mesothelioma and Pleural Effusions Quiz
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Questions and Answers

What percentage of patients with malignant mesothelioma are not alive within one year of diagnosis?

  • 50-70%
  • 80-90%
  • 60-80% (correct)
  • 30-50%

    • The majority of malignant mesothelioma cases arise from the peritoneum rather than the pleura.

    False

    What are the main symptoms of malignant mesothelioma?

    Chest pain and dyspnea.

    Malignant mesothelioma is a neoplasm that aggressively originates from mesothelial cells in the _____ and is associated with asbestos exposure.

    <p>pleura</p> Signup and view all the answers

    Match the following types of malignant mesothelioma with their characteristics:

    <p>Epitheloid type = Most common type, characterized by cells resembling epithelial cells Sarcomatoid type = Less common, more aggressive with spindled cells Biphasic mesothelioma = Contains both epithelioid and sarcomatoid cells Peritoneal mesothelioma = Occurs in the peritoneal cavity and may lead to disseminated nodules</p> Signup and view all the answers

    Which type of pleural effusion is characterized by air in the pleural space?

    <p>Pneumothorax</p> Signup and view all the answers

    Hydrothorax is typically associated with inflammatory conditions.

    <p>False</p> Signup and view all the answers

    What is the common cause of hemothorax?

    <p>Rupture of an intrathoracic aortic aneurysm</p> Signup and view all the answers

    Chylothorax is characterized by the accumulation of ______ fluid in the pleural space.

    <p>lymphatic</p> Signup and view all the answers

    Match the following pleural effusions with their characteristics:

    <p>Hydrothorax = Transudate accumulation Hemothorax = Presence of blood Chylothorax = Milky lymphatic fluid Pneumothorax = Air in pleural space</p> Signup and view all the answers

    What is the most common cause of inflammatory pleural effusions?

    <p>Bronchogenic carcinomas</p> Signup and view all the answers

    List the two main categories of pleural effusions.

    <p>Inflammatory and non-inflammatory</p> Signup and view all the answers

    What is a common appearance of chylothorax in patients on a normal diet?

    <p>White and milky</p> Signup and view all the answers

    Pneumothorax occurs only in cases of injury or trauma.

    <p>False</p> Signup and view all the answers

    Name one condition that can lead to obstruction of the thoracic duct in animals.

    <p>Tumors</p> Signup and view all the answers

    Fibrinous pleuritis is commonly caused by _____ diseases such as rheumatoid arthritis or lupus.

    <p>collagen</p> Signup and view all the answers

    Which of the following is NOT a cause of inflammatory pleural effusion?

    <p>Normal lung function</p> Signup and view all the answers

    A pneumothorax can lead to a total collapse of the lung.

    <p>True</p> Signup and view all the answers

    What type of pleuritis often heals without leaving a trace?

    <p>Transudate and serous exudate pleuritis</p> Signup and view all the answers

    Match the following conditions with their characteristics:

    <p>Chylothorax = White and milky fluid presence Pneumothorax = Presence of air in pleural space Fibrinous pleuritis = Caused by collagen diseases Inflammatory pleural effusion = Can be hemorrhagic</p> Signup and view all the answers

    The common complications associated with chronic pleurisy include _____ and interference with respiratory movements.

    <p>empyema</p> Signup and view all the answers

    What condition is characterized by a large amount of pus collection in the pleura?

    <p>Purulent pleuritis</p> Signup and view all the answers

    Liver abscess is commonly associated with tuberculous pleuritis.

    <p>True</p> Signup and view all the answers

    What is the primary gene rearrangement associated with solitary fibrous tumors?

    <p>NAB2-STAT6</p> Signup and view all the answers

    The condition known as Doege-Potter syndrome is associated with the production of ______ by the solitary fibrous tumor.

    <p>IGF2</p> Signup and view all the answers

    Match the following tumors with their characteristics:

    <p>Solitary fibrous tumor = Benign tumor with NAB2-STAT6 gene rearrangement Mesothelioma = Malignant tumor associated with asbestosis Benign cystic mesothelioma = Rare at pleura, more common at peritoneum Malignant mesothelioma = Usually associated with environmental carcinogens</p> Signup and view all the answers

    Which imaging technique shows solitary fibrous tumors as isodense to skeletal muscle?

    <p>CT scan</p> Signup and view all the answers

    Chronic tuberculous empyema is typically asymptomatic.

    <p>False</p> Signup and view all the answers

    What type of pleural tumor is known to rarely be associated with asbestosis?

    <p>Benign cystic mesothelioma</p> Signup and view all the answers

    The cut surface of solitary fibrous tumors may show ______ or cystic areas.

    <p>hemorrhagic</p> Signup and view all the answers

    Which tumor is characterized by haphazardly arranged spindled to ovoid cells?

    <p>Solitary fibrous tumor</p> Signup and view all the answers

    What is the primary characteristic of the histological pattern of solitary fibrous tumors?

    <p>Haphazard arrangement of spindled to ovoid cells</p> Signup and view all the answers

    STAT6 immunohistochemistry is highly sensitive and specific for identifying NAB2-STAT6 gene fusion.

    <p>True</p> Signup and view all the answers

    What is the recurrence rate for solitary fibrous tumors?

    <p>10 - 30%</p> Signup and view all the answers

    The typical survival rates at 5 and 10 years for solitary fibrous tumors are ____% and ____%, respectively.

    <p>89, 73</p> Signup and view all the answers

    Match the following factors with their association in prognostic outcomes:

    <p>Mitotic count &gt; 4 per 10 high power fields = Adverse prognostic factor Tumor size &gt; 10 cm = Adverse prognostic factor TERT promoter mutations = Adverse prognostic factor Location in chest, abdomen, or pelvis = Adverse prognostic factor</p> Signup and view all the answers

    Which of the following is NOT considered an adverse prognostic factor for solitary fibrous tumors?

    <p>Tumor size under 5 cm</p> Signup and view all the answers

    The risk of malignant mesothelioma is significantly increased by asbestos exposure.

    <p>True</p> Signup and view all the answers

    What is the generally accepted percentage risk associated with asbestos exposure for malignant mesothelioma?

    <p>7-10%</p> Signup and view all the answers

    Two important tumor suppressor genes associated with oncogenic mutations in mesothelial cells are ____ and ____.

    <p>p16, CDKN2A</p> Signup and view all the answers

    What type of imaging shows the pleural mass in the case of the 74-year-old man?

    <p>Enhanced chest CT</p> Signup and view all the answers

    Study Notes

    Pleural Diseases

    • Pleural diseases involve the pleura, the lining of the lungs and chest cavity.
    • Visceral pleura lines the lungs, parietal pleura lines the chest wall.
    • The space between these two layers is the intrapleural space (pleural cavity).
    • Pleural effusion is the accumulation of fluid in the pleural space.
    • Types of pleural effusion include: transudative (imbalance in hydrostatic/oncotic pressure), exudative (inflammatory disorders), empyema/pyothorax (purulent fluid), hemothorax (blood), and chylothorax (lymphatic fluid).
    • Pneumothorax is air in the pleural space.
    • Causes of pleural effusions include inflammation (most common: pyogenous bacteria), bronchogenic carcinomas, pulmonary infarct, and viral pleuritis.
    • Non-inflammatory pleural effusions include hydrothorax (transudate), hemothorax, chylothorax, and pneumothorax.
    • The color of pleural effusion can vary and aid in diagnosis; examples are straw, bloody, cloudy, milky white, transparent, green, and black.
    • Etiopathogenesis of hydrothorax; hydrostatic P↗ (congestive heart failure), vascular permeability (pneumonia), oncositic P لا (Nephrotic synd.), pleural negative p (atelectasis), lymphatic drainage لا (mediastinal carcinomatosis).
    • Signs of pleural effusion in a patient may include difficulty breathing, dry cough, sharp chest pain.
    • Treatments for pleural effusion include thoracentesis, chest tube insertion, and management based on underlying cause, as well as pain relief medications.

    Histology of the pleura

    • The pleura has both a visceral and parietal layer.
    • The visceral layer is the inner layer lining the lung.
    • The parietal layer is the outer layer lining the chest wall.

    Pleurisy or Pleuritis

    • Pleurisy is inflammation of the pleura.
    • Causes can be, viral infections, bacterial infections, inflammatory conditions, pulmonary conditions, cardiac conditions, medical side effects.
    • Symptoms include pleuritic chest pain, that worsens with coughing, swallowing, or deep breathing, high pitched breath sounds, dry cough, shortness of breath, fever, chills, and fatigue.
    • Treatment can include NSAIDs for pain relief, antibiotics for bacterial infections, medical intervention to remove excess fluid from the lungs.

    Fibrinous Pleuritis

    • Fibrinous pleuritis involves the accumulation of fibrin in the pleural space, caused by various factors.
    • These factors include collagen diseases (rheumatoid arthritis, SLE), tuberculosis, uremia, lung abscess, lung infarct, radiotherapy.

    Empyema/Pyothorax

    • Empyema is a collection of pus in the pleural space, arising from bacterial or mycotic lung infection, secondary/primary, lymphogenous or hematogenous, subphrenic or liver abscess, peritonitis.
    • Empyema is often associated with pneumonia or lung abscess.
    • Empyema can be treated medically and surgically.

    Pleural Tumors

    • Solitary fibrous tumor (SFT) is a benign tumor of the serous tissues.
    • Benign cystic mesothelioma is a rare type of pleural tumor.
    • Malignant mesothelioma is a rare, aggressive tumor linked to asbestos exposure.
    • Pleural metastases are more common than primary tumors, and often originate from the lungs, breasts, and stomach.

    Mediastinal Tumors

    • Upper mediastinal tumors frequently include lymphoma, thymoma, thyroid lesions, metastatic carcinoma, and parathyroid tumors.
    • Mid-mediastinal tumors commonly include thymoma, teratoma, lymphoma, thyroid lesions, and parathyroid tumors.
    • Posterior mediastinal tumors commonly include neurogenic tumors, lymphoma, gastroesophageal hernia, bronchogenic cysts, pericardial cysts.

    Thoracentesis

    • Thoracentesis is a procedure to drain fluid from the pleural space.

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    Related Documents

    Pleural Diseases PDF

    Description

    Test your knowledge on malignant mesothelioma and various types of pleural effusions. This quiz covers symptoms, classifications, and characteristics related to this aggressive neoplasm. Brush up on your understanding of clinical aspects and associated conditions.

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