Enhanced Verifiable CPD from the
University of Birmingham

Dentaljuce Shorts: 500 words, 10 MCQs, on general medicine and surgery.


Mesothelioma is a type of cancer originating from the thin layer of tissue covering many internal organs, known as the mesothelium. The most commonly affected area is the lining of the lungs and chest wall, but it can also affect the abdomen, heart, and testes. Mesothelioma is heavily associated with asbestos exposure, with symptoms typically manifesting 20 to 50 years post-exposure.

Signs and Symptoms


Symptoms of pleural mesothelioma include chest wall pain, pleural effusion (fluid surrounding the lung), shortness of breath, fatigue, wheezing, hoarseness, cough, and hemoptysis (blood in sputum). In severe cases, patients may present with multiple tumour masses and pneumothorax (collapsed lung).

CT scan showing a left sided mesothelioma with an enlarged mediastinal lymph node
CT scan showing a left sided mesothelioma with an enlarged mediastinal lymph node


Peritoneal mesothelioma symptoms include abdominal swelling and pain due to ascites (fluid buildup), weight loss, fever, night sweats, poor appetite, vomiting, constipation, and umbilical hernia. Late-stage symptoms may involve difficulty swallowing and swelling of the neck or face.


Pericardial mesothelioma can present with constrictive pericarditis, heart failure, pulmonary embolism, and cardiac tamponade. Other symptoms include substernal chest pain, orthopnea (difficulty breathing when lying flat), and cough due to the tumour encasing or infiltrating the heart.


In severe cases, signs and symptoms may include blood clots in veins (thrombophlebitis), disseminated intravascular coagulation (severe bleeding), jaundice, low blood sugar, pleural effusion, pulmonary embolism, and severe ascites.



Asbestos exposure is the primary risk factor for mesothelioma, with high incidence in populations near naturally occurring asbestos or in those involved in mining, producing, or working with asbestos products. Other risk factors include genetic predispositions and exposure to erionite, a zeolite mineral. Pericardial mesothelioma may not always be linked to asbestos exposure.


Mesothelioma development involves asbestos fibres penetrating lung tissue and reaching the pleural surface. This leads to the formation of malignant mesothelial plaques. The fibres can also be transported to the abdomen via the lymphatic system. Asbestos acts as a complete carcinogen, with direct physical interactions with mesothelial cells and indirect effects through inflammatory responses.

Diffuse pleural mesothelioma with extensive involvement of the pericardium
Diffuse pleural mesothelioma with extensive involvement of the pericardium



Mesothelioma diagnosis relies on imaging techniques such as chest X-rays, CT scans, and MRIs. These can reveal pleural thickening and fluid buildup, indicative of mesothelioma. Advanced imaging may be required for further evaluation.

CXR demonstrating a mesothelioma
CXR demonstrating a mesothelioma


A definitive diagnosis is made through a biopsy, where tissue samples are examined under a microscope. Techniques include thoracoscopy, thoracotomy, and laparoscopy, depending on the tumour's location.


Immunohistochemical tests help differentiate mesothelioma from other cancers, using markers such as calretinin and WT1.



Surgery options include pleurectomy/decortication, removing the chest lining, and extrapleural pneumonectomy, removing the lung, chest lining, diaphragm, and pericardium. Complete tumour removal is often not possible.


Radiation therapy can be used post-surgery to treat the hemithorax or as palliative care to relieve symptoms. Its efficacy varies and can induce severe side effects.


Chemotherapy has shown to improve survival in mesothelioma patients. The combination of cisplatin and pemetrexed is effective, with vitamin supplementation reducing side effects.


Recent advancements include the FDA approval of nivolumab and ipilimumab for unresectable malignant pleural mesothelioma, showing improved survival rates.


Mesothelioma generally has a poor prognosis, with typical survival between 12 and 21 months post-diagnosis. Prognosis is better in women, younger individuals, and those with epithelioid histology. Negative prognostic factors include sarcomatoid histology and high platelet counts.

Micrographs showing conventionally-stained mesothelioma in a core biopsy (higher magnifications on right)
Micrographs showing conventionally-stained mesothelioma in a core biopsy (higher magnifications on right)

Self-assessment MCQs (single best answer)

Which area is most commonly affected by mesothelioma?

What is the primary risk factor for developing mesothelioma?

Which of the following is NOT a symptom of pleural mesothelioma?

What imaging technique is commonly used to reveal pleural thickening and fluid buildup indicative of mesothelioma?

What biopsy technique is used to diagnose mesothelioma in the chest area?

Which marker is used in immunohistochemical tests to help differentiate mesothelioma from other cancers?

Which combination of chemotherapy drugs has shown effectiveness in treating mesothelioma?

Which of the following is a recent advancement in mesothelioma treatment that has shown improved survival rates?

Which type of mesothelioma is associated with symptoms like abdominal swelling and pain due to ascites?

Which of the following is NOT considered a negative prognostic factor in mesothelioma?


Dentaljuce provides Enhanced Continuing Professional Development (CPD) with GDC-approved Certificates for dental professionals worldwide.

Founded in 2009 by the award-winning Masters team from the School of Dentistry at the University of Birmingham, Dentaljuce has established itself as the leading platform for online CPD.

With over 100 high-quality online courses available for a single annual membership fee, Dentaljuce offers comprehensive e-learning designed for busy dental professionals.

The courses cover a complete range of topics, from clinical skills to patient communication, and are suitable for dentists, nurses, hygienists, therapists, students, and practice managers.

Dentaljuce features Dr. Aiden, a dentally trained AI-powered personal tutor available 24/7 to assist with queries and provide guidance through complex topics, enhancing the learning experience.

Check out our range of courses, or sign up now!

Membership Options

Dentaljuce offers a range of membership options…

Regular Membership

With enhanced CPD Certificates. Dentaljuce is brought to you by the award winning Masters team from the School of Dentistry, University of Birmingham, UK. All have won awards for web based learning and teaching and are recognised as leaders and innovators in this field, as well as being highly experienced clinical teachers. Full access to over 100 courses, no extras to pay.

Buy Now

£89.00 per year

Student Membership

No Certificates. With universities cutting down on traditional lectures, many students are currently having to rely more on online resources. If you don't need CPD Certificates, we are offering an amazing discount on your Dentaljuce personal membership fee. Special student price just £29 for 12 months individual membership.

Buy Now

£29.00 per year

This is the Catherine Deneuve of online dentisty.

© Dentaljuce 2024 | Terms & Conditions | Privacy Policy

Recording CPD time: recorded.