Collision tumour of the pleura composed of small cell carcinoma and malignant mesothelioma

Our plain-English summary of Collision tumour of the pleura composed of small cell carcinoma and malignant mesothelioma, by A.H. Lee, I.N. Soomro (Histopathology, 2004).

The study

• Authors: A.H. Lee, I.N. Soomro
• Journal: Histopathology
• Published: 2004;45(3):305-6
• Type of article: Case report, Letter, Comment
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In a letter responding to a report by Attanoos et al. of three cases of mesothelioma intimately admixed with another tumour type, the authors described a case of pleural malignant mesothelioma mixed with small cell carcinoma. They stated that this combination did not appear to have been described before. The patient was an 81-year-old man who had been exposed to asbestos while working in a power station and who also smoked. He died 9 months after pleural malignant mesothelioma was diagnosed on pleural biopsy. At postmortem examination, firm white tumour replaced the lower two-thirds of the right pleura. Pleural plaques were present elsewhere, and tumour deposits were found in the liver, pancreas, adrenals and thyroid gland. Sections of the right pleural tumour showed intermingled malignant mesothelioma and small cell carcinoma. Cytokeratin 5/6, calretinin, HBME-1 and vimentin were expressed only in the mesothelioma. CD56, thyroid transcription factor-1 and carcinoembryonic antigen were expressed only in the small cell carcinoma. Asbestos bodies were noted in the lung, but there was no interstitial pulmonary fibrosis. All metastases showed small cell carcinoma only. The authors concluded that the asbestos exposure history and asbestos bodies were consistent with asbestos causing the mesothelioma. Because there was no asbestosis, they considered that the small cell carcinoma could not be attributed to asbestos and was likely related to smoking. They stated that the small cell carcinoma was the important contributor to death, and that the case emphasized the importance of histology at postmortem examination of mesothelioma.

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 letter to the editor reported a single case from Nottingham, UK. An 81-year-old man had a right pleural tumour that combined malignant mesothelioma and small cell carcinoma, a mixture the authors said did not appear to have been described before. Pleural malignant mesothelioma had been diagnosed on pleural biopsy 9 months before he died. He had a history of asbestos exposure while working in a power station and also smoked. The article did not name a fiber type. At postmortem, tumour replaced the lower two-thirds of the right pleura, and pleural plaques were present elsewhere. The two cancer types were intermingled and were told apart with special stains. Asbestos bodies were found in the lung, but there was no interstitial pulmonary fibrosis. Tumour deposits in the liver, pancreas, adrenals and thyroid showed small cell carcinoma only. The authors concluded that the asbestos findings were consistent with asbestos causing the mesothelioma. Because there was no asbestosis, they said the small cell carcinoma could not be attributed to asbestos and was likely related to smoking. They judged it the important contributor to his 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 (letter to the editor)
• Who was studied: One 81-year-old man, examined at postmortem by the Histopathology Department, Nottingham City Hospital, UK. He had been diagnosed with pleural malignant mesothelioma on pleural biopsy 9 months before his death.
• Exposure: Asbestos exposure while working in a power station (no fiber type stated). He also smoked.
• Main results:
  • At postmortem, firm white tumour replaced the lower two-thirds of the right pleura. Pleural plaques were present elsewhere.
  • The right pleural tumour showed two intermingled patterns: malignant mesothelioma (papillary groups of pleomorphic epithelioid cells) and small cell carcinoma.
  • Stains separated the two components. Cytokeratin 5/6, calretinin, HBME-1 and vimentin were expressed only in the mesothelioma. CD56, thyroid transcription factor-1 and carcinoembryonic antigen were expressed only in the small cell carcinoma. Epithelial membrane antigen and CAM5.2 were expressed in both.
  • Asbestos bodies were found in the lung, but there was no interstitial pulmonary fibrosis.
  • Tumour deposits were present in the liver, pancreas, adrenals and thyroid gland. All sections of these metastases showed small cell carcinoma only.
• The authors' conclusion: The authors concluded that the asbestos exposure history and asbestos bodies were consistent with asbestos being the cause of the mesothelioma. Because there was no asbestosis, they said the small cell carcinoma could not be attributed to asbestos exposure and was likely related to smoking. Since only the small cell carcinoma had metastasized, they considered it the important contributor to the man's death.

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: Pleura, Carcinoma, Mesothelioma, Pleural Biopsy, Pleural Plaques, Cytokeratin 5/6, Calretinin, HBME-1.

Related studies

• Immunohistochemical analysis still has a limited role in the diagnosis of malignant mesothelioma. A study of thirteen antibodies — F. Roberts, C.M. Harper, et al. (2001)
• Comparative genetic analysis of a rare synchronous collision tumor composed of malignant pleural mesothelioma and primary pulmonary adenocarcinoma — T. Naka, Y. Hatanaka, et al. (2016)
• Expression of the small cell carcinoma antigens of cluster-5 and cluster-5A in primary lung tumours — A. Maier, U. Schmidt, et al. (1989)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Expression of calretinin, thrombomodulin, keratin 5, and mesothelin in lung carcinomas of different types: an immunohistochemical analysis of 596 tumors in comparison with epithelioid mesotheliomas of the pleura — M. Miettinen, M. Sarlomo-Rikala (2003)
• Extrapulmonary small cell carcinoma mimicking malignant pleural mesothelioma — K. Noguchi, N. Fujimoto, et al. (2013)

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