الفهرس | Only 14 pages are availabe for public view |
Abstract This study was conducted in Abbassia chest hospital on 20 patients with malignant pleural mesothelioma after confirmation with thoracoscopic tissue biopsy. The enrolled patients were subjected to: Medical thoracoscopy : -which was performed under local anaesthesia (single port of entry technique). -All apparently abnormal (suspicious) areas seen were biopsied for histopathological examination. Re-reading of CT scan of the chest after confirmation of MPM with tissue biopsy. from the present study, the following results were obtained: Out of 20 cases with MPM, 12 patients were males representing (60%) and 8 were females representing (40%), with mean age 46.3 ±7.43. About 14 of the patients presented with massive pleural effusion, and 6 patients presented with moderate pleural effusion. Cytological examination was positive for malignant cells in 2 patients representing 10% of the cases and negative in 18 patients representing 90% of the patients. CT chest was able to detect costal pleural thickening in 87.5% of the cases detected by thoracoscopy, costal pleural nodules seen by CT only in 4 cases out of 20 seen by medical thoracoscopy. Visceral pleural invasion was not detected by CT chest, but medical thoracoscopy detect visceral pleural nodules in 13 cases. In diaphragmatic pleural assessment medical thoracoscopy was superior to CT scan, as thoracoscopy detect diaphragmatic pleural nodules in 13 cases which were not detected by CT at all. According to CT findings which are suggestive of malignancy(circumferential pleural thickening, nodular pleural thickening, parietal pleural thickening more than 1cm and mediastinal pleural involvement) CT was able to predict malignancy in 70% of the cases. CT chest detected fibrous septation only in 1 case out of 3 detected by medical thoracoscopy. |