A left pleural effusion with a calcified tumoral mass and left hemithoracic uptake on bone scan

Our plain-English summary of A left pleural effusion with a calcified tumoral mass and left hemithoracic uptake on bone scan, by E. Quoix, M.P. Chenard, B. Orion, et al (Lung Cancer, 2001).

The study

• Authors: E. Quoix, M.P. Chenard, B. Orion, G. Lang-Averous, A. Dopff-Kaissling
• Journal: Lung Cancer
• Published: 2001;32(2):203-5
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Diffuse malignant pleural mesothelioma is a rare primary tumor of the pleura with three principal histological types, epithelial; mesenchymal and mixed epithelial and mesenchymal. We report here a case of a mesenchymal mesothelioma with foci of osteosarcomatous degeneration revealed by dense calcifications associated with the pleural effusion on the computed tomography (CT) of the thorax. The bone scan revealed extraosseous uptake corresponding to the left pleura.

In plain English

This article was a case report about one patient: a 76-year-old man, a former smoker, admitted after two months of increasing shortness of breath and left chest pain. Before retirement he had worked as a cooper and a packer, and the ceiling of the factory where he worked was covered with asbestos. The article does not name a fiber type. A chest X-ray showed a large left pleural effusion with dense calcifications. A first drainage of the chest yielded 700 cm3 of bloody fluid, and a second drainage removed 1300 cm3. A CT scan showed heavily calcified masses next to the pleura. Thoracoscopy found whitish, firm nodules and plaques on the parietal pleura, most of them calcified. Biopsy led to a diagnosis of desmoplastic sarcomatous mesothelioma with foci of osteogenic (bone-forming) sarcoma. A bone scan showed several spots of uptake in the left chest that matched the calcified masses. The authors concluded that the bone scan confirmed no osteogenic sarcoma elsewhere and may add an argument for a malignant pleural mesothelioma that had differentiated into osteogenic sarcoma. A single case does not show how often this happens.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report
• Who was studied: One 76-year-old man, a former smoker, admitted to a chest disease department after a 2-month history of increasing shortness of breath and left thoracic pain. The authors were based at hospitals in Strasbourg and Saverne, France. The date of admission is not given.
• Exposure: Before retirement he worked as a cooper and a packer. The ceiling of the factory where he worked was covered with asbestos. No fiber type or dose is given.
• Main results:
  • In this patient, the first thoracentesis yielded 700 cm3 of bloody fluid. A second thoracentesis yielded 1300 cm3; the article does not describe the appearance of that fluid.
  • In this patient, CT of the thorax showed heavily calcified masses adjacent to the pleura.
  • In this patient, thoracoscopy showed a normal visceral pleura. The parietal pleura carried whitish firm nodules about half a centimeter in size, with dense plaques at the base of the lung. Most of the nodules and plaques appeared calcified.
  • In this patient's biopsy, atypical spindle cells stained positive for both cytokeratin and vimentin. The poorly differentiated sarcomatous areas forming osteoid bone were cytokeratin-negative.
  • This patient's diagnosis was desmoplastic sarcomatous mesothelioma with foci of osteogenic sarcoma.
  • In this patient, the bone scan showed several foci of uptake on the left hemithorax corresponding to the dense calcified masses, and was otherwise unremarkable.
• The authors' conclusion: The authors concluded that in this case the bone scan confirmed the absence of osteogenic sarcoma elsewhere. They wrote that it may provide an additional argument in favor of a malignant pleural mesothelioma with differentiation into osteogenic sarcoma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Effusion, Pleural Mesothelioma, Pleura, Mesothelioma, Thorax.

Related studies

• Osteosarcoma pleural effusion: A diagnostic challenge with some cytologic hints — B. AbdullGaffar (2021)
• Unilateral Ga-67 uptake in the hemithorax after recurrence of pleural effusion — G. Panoutsopoulos, K. Syrigos, et al. (2001)
• Calcified interlobar pleural plaques: visceral pleural involvement due to asbestos — E.N. Sargent, J.S. Felton, et al. (1981)
• Calcified plaques on mediastinal pleural reflections associated with asbestos dust exposure: four case reports — A. Solomon, G.K. Sluis-Cremer, et al. (1984)
• Calcified plaque in the superior portion of the major fissure. An unusual manifestation of asbestos exposure — S.B. Rupp, H. Jolles (1989)
• Dyspnea with slow-growing mass of the left hemithorax — N. Patel, A. Bishay, et al. (2007)

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