000			02678nam a22002417a 4500
999			_c10221 _d10221
003			MED20160002
005			20240720152931.0
008			171018b xxu||||| |||| 00| 0 eng d
040			_cFEU-NRMF MEDICAL LIBRARY
041			_aENGLISH
050			_aMED20160002
100			_aAguinaldo, Ralph Allan D., MD. _eauthor
245			_aTB or not TB : _ban unexpected case of malignant pleural mesothelioma / _cRalph Allan D. Aguinaldo.
260			_aFairview, Quezon City _bDepartment of Medicine, FEU-NRMF, _c2016
300			_a13 pages: _c(in folder)
336			_2text _ardacontent
337			_2unmediated _ardamedia
338			_2volume _ardacarrier
504			_aIncludes appendices and bibliographical references.
520			_aABSTRACT: A 40-year old male was admitted due to difficult of breathing and right-sided chest pain. He was initially treated as a case of pulmonary tuberculosis for 2 months but was reevaluated afterrecurrence of symptoms. Upon obtaining an occupational history wherein he had worked in various textile and furniture factories but denied history of asbestos exposure, further diagnostics including repeat pleural fluid analysis, chest CT scan with contrast and pleural biopsy revealed he has malignant pleural mesothelioma (MPM), rare yet emerging disease of the 21st century. It is most often associated with asbestos exposure, but patients can still develop the disease without vacuolating virus (SV40) as other possible causative agents. With long latency period between exposure and diagnosis between 20-60 years, the incidence of MPM is expected to peak in the year 2020. The disease most commonly develops when large amphibole asbestos fibers enters the lung parenchyma upon inhalation and then deposits into the lymph nodes and pleura, where they cause oxidative stress over a long period of time, eventually leading to cancer. Diagnosis involves recognition of typical signs and symptoms of MPM, namely dyspnea due to large pleural effusion and chest wall pain due to tumor invasion. In such patients, comprehensive occupational history with emphasis on asbestos exposure is warranted. Tissue biopsy is essential in the diagnosis, and immunohistochemistry should be done whenever possible. Treatment mainly involves combination chemotheraphy with cisplatin/carboplatin plus pemetrexed/raltitrexed, but surgery and radiotheraphy may be useful adjuvants. To date, prognosis is poor in all stages of the disease. In conclusion, as the incidence of MPM has been steadily increasing over the years, awareness of the disease can increase the chances of early diagnosis and improve quality of life.
521			_aRESDM
942			_2lcc _cRE