Antemortem diagnosis in two cases of malignant peritoneal mesothelioma

Our plain-English summary of Antemortem diagnosis in two cases of malignant peritoneal mesothelioma, by B. Eslami, C.L. Lutcher (The American Journal of the Medical Sciences, 1974).

The study

• Authors: B. Eslami, C.L. Lutcher
• Journal: The American Journal of the Medical Sciences
• Published: 1974;267(2):117-21
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This case report described two patients whose malignant peritoneal mesothelioma, a cancer of the abdominal lining, was diagnosed before death. The first, a 62-year-old salesman referred to Eugene Talmadge Memorial Hospital, had weakness, weight loss and fluid in the abdomen. A biopsy taken by peritoneoscopy, a scope inserted into the abdomen, was read as consistent with mesothelioma or an inflammatory reaction. The Armed Forces Institute of Pathology then confirmed mesothelioma. He died, and autopsy found papillary mesothelioma involving the peritoneum, bowel, diaphragm and right pleura. The second, a woman bookkeeper, had exploratory surgery at a local hospital and was first treated for suspected tuberculous peritonitis, until her biopsy was interpreted as mesothelioma. She was then referred to Talmadge Hospital and died 18 months after her illness began. Neither patient had a history of asbestos exposure, and the first patient's lung sections showed no asbestos bodies. Both had raised platelet counts and positive tests for clotting breakdown products. Six tuberculosis patients the authors tested showed no abnormal results on such tests. The authors concluded that peritoneoscopy and coagulation screening studies are important aids for diagnosis before death.

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 of two patients
• Who was studied: Two patients with malignant peritoneal mesothelioma, both eventually referred to Eugene Talmadge Memorial Hospital (Department of Medicine, Medical College of Georgia, Augusta, Georgia). One was a 62-year-old male salesman. The other was a female bookkeeper whose illness began in October 1969 and who was first evaluated at a local hospital.
• Exposure: Neither patient had a history of asbestos exposure. Review of lung sections from patient No. 1 did not reveal asbestos bodies. No fiber types were discussed for these patients.
• Main results:
  • Patient 1: a biopsy of a peritoneal nodule showed mesothelial cell hyperplasia and was interpreted as consistent with malignant peritoneal mesothelioma or a reactive inflammatory process. The diagnosis of malignant peritoneal mesothelioma was confirmed by the Armed Forces Institute of Pathology.
  • Patient 1 died. Necropsy showed papillary mesothelioma diffusely involving the peritoneum, bowel, diaphragm and visceral pleura of the right pleural cavity, with no evidence of diffuse intravascular clotting or other malignancy.
  • Patient 2: she was admitted to a local hospital and underwent exploratory laparotomy. Tuberculous peritonitis was suspected and antituberculous drugs were started. Her biopsy was then interpreted by the Armed Forces Institute of Pathology as malignant peritoneal mesothelioma. Antituberculous therapy was stopped and she was referred to Talmadge Hospital.
  • Patient 2 received multiple-agent chemotherapy for two months, was lost to follow-up, and died 18 months after the onset of her illness.
  • Coagulation screening: patient 1 had a moderate increase in platelets and positive serum Fi and plasma protamine tests. Patient 2 had marked thrombocytosis and positive serum Fi and plasma protamine tests. Both patients showed thrombocytosis together with fibrinogen-fibrin degradation products.
  • The authors performed thrombin times, serum Fi tests and protamine tests in five patients with pulmonary tuberculosis and one with tuberculous peritonitis, and noted no abnormal results.
• The authors' conclusion: The authors concluded that peritoneoscopy and coagulation screening studies are important diagnostic aids in making an antemortem diagnosis of malignant peritoneal mesothelioma. Their abstract words this more cautiously, as 'may be important'.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma.

Related studies

• Malignant peritoneal mesothelioma — V. de Pangher Manzini (2005)
• Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies — G. Passot, N. Bakrin, et al. (2014)
• Rectus abdominis muscle resection for abdominal wall recurrence of mucinous adenocarcinoma or peritoneal mesothelioma — T. Yan, P. Sugarbaker (2008)
• Antemortem diagnosis of asbestosis by screening chest radiograph correlated with postmortem histologic features of asbestosis: a study of 273 cases — K.N. Mizell, C.G. Morris, et al. (2009)
• Preoperative Thrombocytosis Predicts Shortened Survival in Patients with Malignant Peritoneal Mesothelioma Undergoing Operative Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy — Y.C. Li, T. Khashab, et al. (2017)
• Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up — S. Kusamura, V. Kepenekian, et al. (2021)

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