Mesothelioma Navy Mesothelioma Navy Quality & Compliance 4

Question 1

Which biopsy method is considered the gold standard for definitively diagnosing malignant pleural mesothelioma in a Navy veteran?

Accepted Answer

Thoracoscopic (VATS) pleural biopsy with immunohistochemical staining

Answer

Video-assisted thoracoscopic surgery (VATS) with pleural biopsy followed by immunohistochemical staining is the gold standard for confirming a mesothelioma diagnosis.

Question 2

The International Mesothelioma Interest Group (IMIG) staging system for pleural mesothelioma uses Stage I through IV. What does Stage IV designation mean for treatment compliance planning?

Accepted Answer

Distant metastases are present, typically limiting curative surgical options

Answer

IMIG Stage IV indicates distant metastatic spread, which generally excludes patients from curative surgery and shifts compliance planning toward systemic therapy and palliative care.

Question 3

Under NCCN (National Comprehensive Cancer Network) guidelines, which first-line chemotherapy regimen is recommended for unresectable pleural mesothelioma?

Accepted Answer

Cisplatin plus pemetrexed (Alimta)

Answer

Cisplatin plus pemetrexed is the NCCN-recommended first-line chemotherapy combination for unresectable malignant pleural mesothelioma, with demonstrated survival benefit in clinical trials.

Question 4

Quality compliance in mesothelioma pathology requires distinguishing mesothelioma from lung adenocarcinoma. Which biomarker panel is most commonly used?

Accepted Answer

Calretinin and WT-1 (positive in mesothelioma) vs. TTF-1 and Napsin A (positive in adenocarcinoma)

Answer

Pathologists use a panel including calretinin and WT-1 (mesothelioma markers) versus TTF-1 and Napsin A (adenocarcinoma markers) to ensure accurate differential diagnosis.

Question 5

A quality mesothelioma center must offer palliative pleurodesis for symptomatic pleural effusion. What is the PRIMARY goal of this procedure?

Accepted Answer

Prevent fluid from re-accumulating in the pleural space to relieve breathlessness

Answer

Pleurodesis creates adhesions between pleural layers to prevent recurrent fluid accumulation, providing significant relief from the breathlessness caused by malignant pleural effusion.

Mesothelioma Navy Practice Test

Mesothelioma Navy Practice Test

Mesothelioma Navy Mesothelioma Navy Quality & Compliance 4