Diagnosing malignant pleural mesothelioma

Our plain-English summary of Diagnosing malignant pleural mesothelioma, by A.S. Teirstein (Chest, 1998).

The study

• Author: A.S. Teirstein
• Journal: Chest
• Published: 1998;114(3):666-7
• Type of article: Editorial, Comment
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a two-page editorial, not an original study. The author commented on a report by Benard and colleagues, published in the same issue of Chest, on using 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) scanning to tell malignant mesothelioma apart from benign pleural disease. As the editorial described that report, 22 of 24 patients with malignant pleural disease had a positive scan, and two of these had adenocarcinoma rather than mesothelioma. Two patients with malignant mesothelioma had false negative scans, and one of 4 patients with benign pleural disease had a false positive scan. The author wrote that neither FDG-PET nor gallium-67 scans can distinguish malignant mesothelioma from metastatic carcinoma involving the pleura. The author noted that mesothelioma in an occupationally exposed patient is compensable, while the role of asbestos in lung cancer is debated. On that basis the author argued that mesothelioma must be distinguished from carcinoma, which in most patients requires examining pleural tissue from a surgical biopsy. The author concluded that FDG-PET can at best suggest malignancy before biopsy and does not remove the need for a tissue diagnosis.

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: Editorial commenting on another study (Benard and colleagues, same issue of Chest); no original data
• Who was studied: No study population of its own. The editorial discussed the Benard report, which as described included 24 patients with malignant pleural disease and 4 patients with benign pleural disease
• Exposure: Asbestos exposure in general; no fiber types, products or doses named. The editorial concerned diagnosis in patients with asbestos exposure and pleural disease
• Main results:
  • As described in the editorial, in the Benard report 22 of 24 patients with malignant pleural disease had a positive FDG-PET scan
  • Of those 22 positive patients in the Benard report, two had adenocarcinoma, not mesothelioma
  • Two patients with malignant mesothelioma in the Benard report had false negative FDG-PET scans
  • There was one false positive among 4 patients with benign pleural disease in the Benard report
  • Metastatic mediastinal lymph nodes were identified in 12 patients in the Benard report
  • The author stated that neither FDG-PET nor gallium-67 scans can distinguish malignant mesothelioma from metastatic carcinoma involving the pleura
  • The author stated that mesothelioma in an occupationally exposed patient is compensable, while the role of asbestos in lung cancer is debated
  • The author stated that it is therefore necessary to differentiate mesothelioma from carcinoma, and that in most patients this can be done only by examining pleural tissue obtained by surgical biopsy
• The authors' conclusion: The author concluded that FDG-PET scanning can at best suggest malignancy before a biopsy but does not remove the need for a tissue diagnosis. The author added that it may help, alongside CT and MRI, in choosing who needs biopsy and where

Topics

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

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

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