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Main Article: Mesothelioma Most Probably or B. Carcinoma or ILD


43 years old male patient complaining of severe dyspnea on exertion not at rest, Cyanosis on exertion, and dull aching pain over the whole chest. Condition has been started 45 days ago with tolerable dyspnea and high fever, condition was gradually progressive then went to a hospital 15 days later, he was admitted there for 5 days then referred to the Kasr al Ainy hospital on 8 February 2015. Chest X-ray, broncos copy and intercostal tube insertion is done, Result of it are not yet out. But release of fluid through intercostal tube on daily basis showed on the picture.

 Remember patient was working in the factory of cloths and cigarette smoker, 40 cigarettes per day since 15 years old. No cough with sputum at all, no LL edema, no clubbing of fingers. To diagnose clinically read the below article..
..Mesothelioma means cancer of mesothelial cells of boby  tissues especially pleural cavity lining  of the lungs all due to prolonged  exposure to asbestose mainly  . Mesothelial cells also found in the peritonial cavity lining  of abdomen and pericardium.

After inhalation of  Asbestose fibers, it  penitrated the lung parenchyma then enter into pleural surface with long exposure. The macrophage engulf the asbestose fiber and secrets hydroxil redicals. Asbestose attack the DNA of mesothelial cells and activate the oncogen, prevent apoptosis and  suppress tumor suppressor genes as a result cancer developed.
Investigation: chest x-ray, CT and suspected tissue biopsy.
Treatment: chemotherapy like cisplatin and pementrexed drugs they induce apoptosis of cancer cells,  or  radiotherapy or surgery.

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