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NCCN Guidelines for Patients



Malignant Pleural Mesothelioma, Version 1.2016

In Part 1, you will learn about cancer

cells and where mesothelioma grows in

the body.

What is a mesothelium?

The lungs are covered by a double layer of thin

tissue called the pleura. The pleura protects and

cushions the lungs. It has an inner layer called the

visceral pleura. It is directly attached to the lungs and

extends down into the spaces between the lobes

of the lungs. The outer layer is calleed the parietal

pleura. It lines the chest wall and has contact with

many body parts in the chest. See

Figure 1.

The chest wall is the layer of muscle and bones

under the skin in the chest area. The pleura is made

of mesothelium and connective tissue.



Mesothelium is a single layer of cells that

makes lubricating fluid and lines most organs

inside the body.



Connective tissue supports the mesothelium

and supplies it with blood. Connective tissue

attaches the pleura to other body parts.

There is space between the visceral and parietal

pleura called the pleural cavity. It is filled with a small

amount of pleural fluid made by the mesothelium.

Pleural fluid acts as a lubricant. It helps the two

pleural layers slide against each other during

breathing. Pleural fluid also helps the lungs glide

against other organs, such as the heart.

The same type of tissue as the pleura is found in

other areas of the body. However, it is called other

names. The tissue lining around the heart is called

the pericardium. The tissue lining around the belly

(abdomen) is called the peritoneum.

How does mesothelioma start?

Cancer is a disease of cells. Abnormal changes

(mutations) in genes can turn normal cells into

cancer cells. Genes are instructions in cells for

making new cells and controlling how cells behave.

Gene mutations cause cancer cells to act differently

than normal cells.

Normal cells grow and then divide to form new cells

as the body needs them. When normal cells grow old

or get damaged, they die. Cancer cells don’t do this.

Cancer cells make new cells that aren’t needed and

don’t die quickly when old or damaged. Over time,

the cancer cells grow and divide enough to form a

mass called the primary tumor. If the primary tumor

isn’t treated, it can grow and invade nearby tissues

and organs, such as the lungs.

Unlike normal cells, cancer cells can spread and

form tumors in other parts of the body. Cancer that

has spread is called a metastasis. Cancer cells often

spread through lymph or blood. Lymph is a clear

fluid that gives cells water and food. It also has white

blood cells that fight germs. Lymph nodes are groups

of disease-fighting cells that filter lymph and remove

the germs. Lymph travels throughout the body in

vessels like blood does. As shown in

Figure 2


lymph vessels and nodes are found everywhere in

the body.

Malignant pleural mesothelioma is the medical name

for cancer that starts in the mesothelium of the lungs.

It is also simply called mesothelioma. It isn’t lung

cancer. Lung cancer begins inside the lungs.


About mesothelioma

What is a mesothelium?

How does mesothelioma start?