Desmoplastic malignant mesothelioma

Our plain-English summary of Desmoplastic malignant mesothelioma, by A. Baççioğlu, E. Kaba, S.A. Ozmen, et al (Journal of Bronchology & Interventional Pulmonology, 2013).

The study

• Authors: A. Baççioğlu, E. Kaba, S.A. Ozmen, M. Demirci
• Journal: Journal of Bronchology & Interventional Pulmonology
• Published: 2013;20(2):155-8
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Desmoplastic mesothelioma is a rare subtype of diffuse malignant mesothelioma. A 72-year-old woman from East Anatolia presented with chest pain. The images of body positron emission tomography revealed irregular, left pleural thickening involving mediastinal and diaphragmatic surfaces with hypermetabolic characterization. The diagnosis of desmoplastic malignant mesothelioma was confirmed by minithoracotomy and immunohistochemical staining with pan-cytokeratin, cytokeratin 5/6, calretinin, carcinoembryonic antigen, thyroid transcription factor-1, CD15, and HMB-45 on the biopsy specimen. This case is unique in terms of the reporting patient being from a nonendemic area for asbestos-related diseases and in terms of its rare histopathology.

In plain English

This article is a case report describing one patient. The patient was a 72-year-old woman, a lifelong nonsmoker, from the village of Agri in Eastern Turkey, which the authors describe as not considered an endemic area for asbestos exposure. Several years earlier she had whitewashed the inside walls of her house with asbestos. The authors also reported that soil in her settlement was contaminated with asbestos from a nearby asbestos mine. The article did not name the fiber type. After 6 months of poor appetite, left-sided chest pain and fatigue, scans showed irregular pleural thickening encasing the whole left lung. Tissue staining of a biopsy confirmed desmoplastic malignant mesothelioma. The tumor was stage II, with no spread to lymph nodes or distant sites. Pleural plaques, pleural calcification, scarring at the bases of both lungs and pleural effusion were absent. Radiation and chemotherapy were proposed. The patient declined them and was alive 9 months after her chest pain began. The authors suggested the case may point to a need for community screening for asbestos-related disease in her settlement, including the degree of asbestos and erionite exposure.

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 72-year-old woman, lifelong nonsmoker, living in the village of Agri in Eastern Turkey, an area the authors say is not considered endemic for asbestos exposure
• Exposure: Household use of asbestos: she had whitewashed the interior walls of her house with asbestos several years earlier. No fiber type was specified.
• Main results:
  • The authors reported that the patient's settlement contained soil contaminated with asbestos because of a nearby asbestos mine. The soil is not known to contain erionite.
  • The patient had lack of appetite, left-sided chest pain and fatigue for 6 months.
  • Positron emission tomography showed hypermetabolic irregular pleural thickening encasing the entire left lung, with a standard uptake value up to 13.22.
  • Minithoracotomy material was reported as desmoplastic mesothelioma. It stained positive for pan-cytokeratin, cytokeratin 5/6 and calretinin, and negative for carcinoembryonic antigen, thyroid transcription factor-1, CD 15 and HMB-45.
  • The tumor was staged as stage II (T2N0M0).
  • The tumor had not spread to the lymph nodes and did not involve distant sites.
  • The patient had pleural thickening, but pleural plaques, pleural calcification, bibasilar fibrosis and pleural effusion were absent.
  • Radiation and chemotherapy were proposed in view of her age. She declined all treatment and was alive at 9 months from the beginning of chest pain.
• The authors' conclusion: The authors concluded that the case may suggest a need for community screening for asbestos-related disease in the patient's settlement, including the degree of asbestos and erionite exposure.

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, Malignant Mesothelioma, Pleural Thickening, Immunohistochemistry, Cytokeratin 5/6, Calretinin, Carcinoembryonic Antigen (CEA), Thyroid Transcription Factor-1 (TTF-1).

Related studies

• BAP1 Immunohistochemistry and p16 FISH in the Diagnosis of Sarcomatous and Desmoplastic Mesotheliomas — H.C. Hwang, S. Pyott, et al. (2016)
• The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining — W.E. Mangano, P.T. Cagle, et al. (1998)
• GATA3 Immunohistochemistry for Distinguishing Sarcomatoid and Desmoplastic Mesothelioma From Sarcomatoid Carcinoma of the Lung — K.B. Berg, A. Churg (2017)
• Keratin and epithelial membrane antigen immunoreactivity in nonneoplastic fibrous pleural lesions: implications for the diagnosis of desmoplastic mesothelioma — J.I. Epstein, R.E. Budin (1986)
• Desmoplastic malignant mesothelioma: a review of 17 cases — G.E. Wilson, P.S. Hasleton, et al. (1992)
• The fake fat phenomenon in organizing pleuritis: a source of confusion with desmoplastic malignant mesotheliomas — A. Churg, P. Cagle, et al. (2011)

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