Atypical carcinoid presenting as mesothelioma

Our plain-English summary of Atypical carcinoid presenting as mesothelioma, by P. van Hengel, F. van Geffen, B.A. Kazzaz, et al (The Netherlands Journal of Medicine, 2001).

The study

• Authors: P. van Hengel, F. van Geffen, B.A. Kazzaz, H.G. Heyerman
• Journal: The Netherlands Journal of Medicine
• Published: 2001;58(4):185-90
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Two patients presented with pleuritic pain and dyspnoe together with pleural thickening on the X-ray of the chest. In both a history of exposure to asbestos existed suggesting mesothelioma. A definite diagnosis could not be made and therefore therapy was symptomatic. Autopsy revealed the unexpected diagnosis of atypical carcinoid of the lung. In one case, pleural spread of tumor was seen while in the other an extensive fibrotic pleural reaction existed. To our knowledge these cases represent the first examples of atypical carcinoid causing pseudomesothelioma.

In plain English

This brief report described two 73-year-old men at a hospital in The Hague, the Netherlands, who had chest pain or breathlessness, thickening or masses of the pleura (the lining around the lungs), and past asbestos exposure at work: likely exposure at a power station in one case and exposure at a shipyard in the other. Mesothelioma was suspected, but no definite diagnosis was made during life: the first patient refused further investigation and the second was too ill for invasive tests. Both died, and autopsy found atypical carcinoid, a neuroendocrine lung tumor, in each. In the first case the tumor had spread through the pleura, some asbestos bodies were found, and the Dutch Mesothelioma Panel confirmed the diagnosis. In the second, the pleura showed bilateral plaques and fibrosis without tumor, and no asbestos bodies were found. The authors noted that the role of asbestos in atypical carcinoid has not been clarified, and concluded that these were, to their knowledge, the first examples of atypical carcinoid causing pseudomesothelioma.

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: Brief report of two cases (case report), with autopsy findings
• Who was studied: Two men, each aged 73, seen by the Department of Pulmonology at Ziekenhuis Leyenburg, The Hague, the Netherlands. Both had a history of chronic obstructive pulmonary disease and of smoking.
• Exposure: Occupational asbestos exposure: likely exposure during a previous job at a power station (case 1) and exposure during a former job at a shipyard (case 2). No fiber type or dose was given.
• Main results:
  • Case 1: the patient refused further investigation, and symptomatic therapy was given without a definite diagnosis during life.
  • Case 2: because of the patient's poor clinical condition, no invasive diagnostic procedures could be done.
  • Case 1: autopsy showed an extensive pleural tumor mass in the upper right chest.
  • Case 1: some asbestos bodies were identified.
  • Case 1: the tumor was classified as an atypical carcinoid, a diagnosis confirmed by the Dutch Mesothelioma Panel.
  • Case 2: autopsy revealed extensive bilateral pleural plaques, more pronounced on the left side.
  • Case 2: the thickened pleura and diaphragm showed fibrosis without evidence of tumor.
  • Case 2: asbestos bodies could not be identified.
  • Case 2: the tumor was classified as a primary atypical carcinoid of the lung with extensive pseudo-mesotheliomatous reactive fibrosis of the pleura.
  • The authors noted that the influence of occupational exposure to carcinogens such as asbestos on atypical carcinoid has not yet been clarified.
• The authors' conclusion: The authors concluded that, to their knowledge, these cases were the first examples of atypical carcinoid causing pseudomesothelioma (a tumor that mimics mesothelioma).

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleuritic Chest Pain, Pleural Thickening, Autopsy, Pseudomesotheliomatous Adenocarcinoma.

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