Advances in diagnosis and management of pleural mesothelioma: the Danish clinical guidelines

Pleural mesothelioma (PM) is a rare, aggressive malignancy of the pleura. The PM diagnosis is challenging, both in terms of imaging, sampling of representative biopsies and pathological examination, and the treatment options are limited. The main aim of this article is to summarize the most recent advances in the diagnosis and management of PM as presented in the Danish clinical guidelines for PM. An expert task force consisting of a lung physician, a pathologist, an oncologist, and a thoracic surgeon conducted an ad hoc literature search during November 2023-July 2024, reviewed the evidence and developed the current clinical guidelines after reaching consensus. The article appraises the radiological modalities and biopsy techniques that are employed in PM diagnostics, provides a comprehensive overview of the evidence behind the PM histopathological and cytological diagnosis, and asserts the state of the art and novel developments of oncological, multimodal, and palliative PM treatment and follow-up that are portrayed in the Danish clinical guidelines.