Bony metastases in desmoplastic pleural mesothelioma

Our plain-English summary of Bony metastases in desmoplastic pleural mesothelioma, by T. Machin, E.T. Mashiyama, J.A. Henderson, et al (Thorax, 1988).

The study

• Authors: T. Machin, E.T. Mashiyama, J.A. Henderson, W.T. McCaughey
• Journal: Thorax
• Published: 1988;43(2):155-6
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

The authors, from Long Beach, California, and Ottawa, Canada, described two patients with desmoplastic pleural mesothelioma, a mainly fibrous variant of diffuse malignant mesothelioma that can be hard to distinguish from fibrous pleurisy. In both, bone metastases were the first clinical evidence that the tumour had spread. A 78 year old man had a left pleural effusion and pleural thickening. Pleural biopsy specimens were interpreted as fibrous pleurisy. Ten months later lytic lesions appeared in the pelvic bones and spine, and an iliac crest biopsy showed fibrous tumour. He died two months later. There was no history of exposure to asbestos. A 70 year old man had breathlessness, chest tightness, cough and right sided chest pain, with a right pleural effusion and thickened pleura (0.4-0.8 cm). Pleural biopsy specimens were interpreted as chronic pleuritis. About five months later lytic areas were seen in both humeri, and bone scans showed increased activity in the humeri, femurs and both 8th ribs. A month after a right humerus biopsy he had a pathological fracture of the left humerus and died shortly after surgery. Neither patient had a necropsy. In retrospect, the authors found that necrosis, nuclear atypia and complex tissue patterns in the pleural biopsies had been clues to tumour. They concluded that the cases emphasised the potential for misdiagnosing diffuse pleural fibrous lesions.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article reported two cases of desmoplastic pleural mesothelioma, an unusual variant of diffuse malignant mesothelioma in which much of the tumour is fibrous. In both men, the first pleural biopsies were read as non-cancerous scarring or inflammation: fibrous pleurisy in a 78-year-old man and chronic pleuritis in a 70-year-old man. Bone metastases were the first clinical sign that the tumour had spread. In the first patient, lytic lesions appeared in the pelvic bones and spine ten months later. A biopsy of the iliac crest (hip bone) showed fibrous tumour, and death followed two months later. In the second patient, lytic areas appeared in both humeri about five months later. Bone scans also showed activity in the femurs and both eighth ribs. This patient had a pathological fracture and died shortly after surgery. Neither patient had a necropsy. The first patient had no history of asbestos exposure; the article does not say whether the second patient was exposed. The authors concluded that both cases emphasise the potential for pathological misdiagnosis of diffuse pleural fibrous lesions.

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 (two cases)
• Who was studied: Two men, aged 78 and 70, with pleural effusions and desmoplastic pleural mesothelioma; the article does not give where or when they were treated
• Exposure: The first patient had no history of asbestos exposure; the article does not report asbestos exposure for the second patient
• Main results:
  • Case 1 (78-year-old man): the pleural biopsy was interpreted as fibrous pleurisy. Ten months later lytic lesions were found in the pelvic bones and spine, and an iliac crest biopsy showed fibrous tumour.
  • Case 1: the patient died two months after the bone lesions were found; no necropsy was done
  • Case 2 (70-year-old man): the pleural biopsy was interpreted as chronic pleuritis. About five months later lytic areas were seen in both humeri.
  • Case 2: a month after a biopsy of the right humerus, the patient had a pathological fracture of the left humerus, was treated by surgical nailing, and died shortly afterwards; no necropsy was done
  • In both cases, bone metastases occurred without clinical evidence of metastases at other sites
• The authors' conclusion: The authors concluded that both cases emphasise the potential for pathological misdiagnosis of diffuse pleural fibrous lesions. They added that, in retrospect, necrosis and nuclear atypia (case 1) and nuclear atypia and complex tissue patterns (case 2) were clues that the tissue was a tumour.

Topics

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

Medical terms in this study, explained in our Lexicon: Desmoplastic Mesothelioma, Pleural Mesothelioma, Malignant Mesothelioma, Pleurisy, Pleural Effusion, Pleural Thickening, Pleural Biopsy, Biopsy.

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