<unk>  is a rare, highly aggressive cancer which arises from the mesothelial cells which form the lining of the pleural, and less frequently the peritoneal, pericardial, and tunica vaginalis cavities.<unk>  is a form of cancer that is most commonly caused by exposure to asbestos. Wagner et al. were the first to discover the association between asbestos exposure and development of<unk> .<unk>  may be classified into several subtypes based on the location (pleural, peritoneal, pericardial, cystic/multicystic, and tunica vaginalis testis), histology (epithelial, sarcomatoid, and biphasic), and potential to spread (benign and malignant). Asbestos causes DNA damage directly by mechanically interfering with the segregation of chromosomes during mitosis and indirectly by inducing mesothelial cells and macrophages, to release mutagenic reactive oxygen and nitrogen species. Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favor the development of<unk> . Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences. Genes involved in the pathogenesis of<unk>  include BAP1, CDKN2A, WT1, NF2, and TP53. On gross pathology, pleural<unk>  is characterized by discrete plaques and nodules that coalesce to produce a sheet-like tumor, with the pleural surface seeding of malignant<unk>  cells. Based on the histology,<unk>  may be classified into 3 subtypes: epithelial, sarcomatoid, and biphagic.<unk>  is demonstrated by positivity to tumor markers, such as calretinin, epithelial membrane antigen, cytokeratin, and mesothelin.<unk>  must be differentiated from pleural effusion, lung cancer, pulmonary tuberculosis, peritoneal tuberculosis, pseudomyxoma peritonei, constrictive pericarditis, ovarian cystadenoma, and mesothelial hyperplasia of the testis. If left untreated,<unk>  may progress to develop dyspnea, dysphagia, pleural effusion, thrombophlebitis, constrictive pericarditis, recurrent hydrocele, and metastases, depending on the site involved. Complications of<unk>  include pleural effusion, spinal cord compression, Horner's syndrome, superior vena cava syndrome, hyperviscocity syndrome, pericardial effusion, cardiac tamponade, heart failure, ascites, and recurrent hydrocele. The prognosis of<unk>  depends on the cell subtype. According to the Union for International Cancer Control staging system, there are four stages of pleural<unk>  based on the primary tumor, lymph nodes, and metastasis: stage I (IA, IB), stage II, stage III, and stage IV. There is no established staging system for peritoneal<unk> . When evaluating a patient for<unk> , you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough family and past medical history review. Other specific areas of focus include a history of any exposure to asbestos or radiation. Symptoms of<unk>  may not appear until 20 to 50 years after exposure to asbestos. Symptoms of<unk>  include chest pain, shortness of breath, cough, abdominal pain, palpitation, hemoptysis, and swelling in the legs.  CT is the most commonly used modality for the assessment of<unk>  and is able to stage the disease accurately in majority of the patients. Chemotherapy is one of the mainstay of therapy for<unk> . Other therapies for<unk>  include radiotherapy, surgery, and supportive care. Effective measures for the primary prevention of<unk>  include removal of asbestos from schools and other public buildings. Secondary prevention strategies following<unk>  include regular checkups, chest x-rays, and/or CT scans in high-risk individuals.
Mesothelioma
Hemangioendothelioma
Bronchoalveolar carcinoma
Large cell carcinoma of the lung
Sarcomatoid carcinoma of the lung
Bronchioloalveolar carcinoma
Sarcoma
Adenocarcinoma of the lung