الفهرس 
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Abstract
The pleural space is enclosed by the visceral pleura, which covers the lungs, and by the parietal pleura, which lines the chest wall, diaphragm, and mediastinum. mesothelial cells form a continuous layer over the whole of the visceral and parietal pleural surfaces. Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos (Wang et al., 1985).
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fiber in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking (Muscat and Wyender, 1991).
Malignant mesothelioma is a highly aggressive primary neoplasm of the pleural, peritoneal, and pericardial surfaces. It is a challenging disease in all aspects, from presentation and diagnosis to staging and treatment (Abdel-Rahman et al., 2007).
The earliest description of primary pleural malignancy was reported before 1900, and several reports suggesting causal effects from asbestos were published in the first half of the 20th century (Roggli et al., 2004).
Asbestos has been recognized in Egypt since a long time as ancient Egyptians were used it in mummification. Mesothelioma in Egypt is mainly attributed to environmental origin with increasing incidence of women and young adults (Gaafar and Aly El-Din, 2005).
This present study was performed in abassia Chest Hospital retrospectively analyzing 600 cases admitted and diagnosed pathologically to be malignant pleural mesothelioma (MPM) between the periods 2006 to 2011.
The data collected from file that full history taking, clinical examination, radiological examination (chest CXR and CT chest), biopsy taking and histopathological examination. The number of cases proved to be rising every year; from 85 (14.2%) in 2007 to 160 (26.6 %) in 2007. with higher incidence in males over females with M: F ratio 2: 1.
The number of cases above 40 years was 560cases representing (93.3%) while 40 cases (6.7%) were below 40 years.
The mean age was 50 years and the range was from 23 - 86 years.
Most of our cases were living in Shobra el khema (185 cases 30.8%), Helwan (165 cases 27.5%), and El kahera (85 cases 14.2%) El kaleobea (55 cases 9.2%) and El mnofea (40 cases 6.7%) The higher numbers of cases reported from Shobra el khema (185 cases) and Helwan (165 cases) may be due to the presence of Siegwart factories in these cities.
The main clinical presentation of cases in our study was shortness of breath of variable grades found in 560 patients (93.3%). followed by chest pain 330 (55.0%), while dry cough found among 265 (44.16%), and productive cough among 335 (55.83%) patients, haemoptysis was rarely found, only among 23 patients (3.83%).
In the present study, the classification of cases according to the diagnostic type of biopsy procedure showed that, 365(60.83%) cases open pleural biopsy and it was found the most common procedure performed, followed by closed pleural biopsies with thoracocentesis using Abrams needle were performed in 155 (25.83 %) of the cases, then CT Guided biopsies done 18(13.33 %) cases.
The analysis of the pathological results of biopsies showed that the epithelial subtype was found to be the most dominant type; 315cases (52.5%). Then the biphasic 120 cases (20.2 %), then the epitheliod 85 cases (14.2 %), while the least one was the sarcomatous type which was 80 cases (13.3%).