Diffuse malignant mesothelioma

Our plain-English summary of Diffuse malignant mesothelioma, by M. Klima, H.J. Spjut, W.D. Seybold (American Journal of Clinical Pathology, 1976).

The study

• Authors: M. Klima, H.J. Spjut, W.D. Seybold
• Journal: American Journal of Clinical Pathology
• Published: 1976;65(5):583-600
• Cited by: 48 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Thirteen cases of diffuse malignant mesothelioma, 12 pleural and one peritoneal, were examined and reviewed from the clinical and morphologic points of view. The most frequent symptom and sign were pain and effusion. Periods of survival varied, with one patient surviving 11 years despite morphologic features of the pleural tumor. The diagnosis can be made only on the basis of excised tumor tissue. The best control of the tumor is attained by repeated surgical removal. Neither radiation nor chemotherapy altered significantly the growth of the tumors.

In plain English

This article described 13 patients with diffuse malignant mesothelioma treated at St. Luke's Episcopal Hospital in Houston over 15 years. Twelve tumors began in the pleura (the chest lining), four of them extending into the peritoneum, and one began in the peritoneum (the abdominal lining). Patients were aged 28 to 69. The main symptom was chest pain on the affected side. X-rays suggested mesothelioma in only one case, and examination of fluid was mostly inconclusive or negative. Eight tumors were mainly gland-like and five sarcoma-like. Under the electron microscope, even sarcoma-like cells had features of epithelial cells. Eleven patients died. Survival from admission to death ranged from 2 months to 11 years. Repeated pleural resections controlled one patient's tumor for seven and a half years. Six patients had possible exposure to asbestos, chemicals or dusts, but none worked in industries known to use asbestos. The authors concluded that surgery seemed to have some effect in controlling the tumor, while radiation and chemotherapy did not alter the disease's course. They noted their group was small.

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 series: clinical and microscopic review of patients seen at one hospital
• Who was studied: 13 patients with diffuse malignant mesothelioma seen over 15 years at St. Luke's Episcopal Hospital, Houston, Texas. Twelve had primary pleural tumors, four of which extended into the peritoneum, and one had a primary peritoneal mesothelioma. Ages were 28 to 69 years, and two patients were women.
• Exposure: Asbestos exposure was not measured. Six patients were considered to have possible exposure to asbestos, chemicals or dusts. None worked in industries known to use asbestos. No fiber type is named.
• Main results:
  • Eleven patients died and two were alive. Among those who died, the shortest survival from admission was 2 months and the longest was 11 years.
  • The predominant symptom was pain in the chest on the affected side.
  • In only one of the 13 cases did the radiologist suggest mesothelioma from the X-rays.
  • Most cytology reports on fluid samples were inconclusive or negative.
  • Eight tumors had a predominantly pseudoglandular (gland-like) pattern and five were predominantly sarcoma-like.
  • Under the electron microscope, the cells of sarcoma-like tumors had features of epithelial cells.
  • In one patient (Patient 4), repeated pleural resections controlled the tumor for seven and a half years.
  • The authors did not see any tumor change from one microscopic type to another, and they found that prognosis could not be predicted from microscopic type.
• The authors' conclusion: The authors concluded that surgery seemed to have some effect in controlling the tumor, while radiation and chemotherapy did not alter the course of the disease. They also found electron microscopy helpful in confirming the diagnosis.
• Limitations the authors state:
  • The patient group was small compared with series published by others.
  • Seven of the eleven deaths were presumed to be from the tumor because no autopsies were done.

Topics

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

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

Related studies

• Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma — G.H. Eltabbakh, M.S. Piver, et al. (1999)
• 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)
• Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma — T.C. Chua, T.D. Yan, et al. (2011)
• Diffuse malignant peritoneal mesothelioma--an update on treatment — P. Mirarabshahii, K. Pillai, et al. (2012)
• Diffuse epithelial mesothelioma: a review of the ultrastructural spectrum — I. Dardick, M. Jabi, et al. (1987)
• The Role of Ki-67 and Pre-cytoreduction Parameters in Selecting Diffuse Malignant Peritoneal Mesothelioma (DMPM) Patients for Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) — S. Kusamura, P.A. Torres Mesa, et al. (2016)

Browse more research in American Journal of Clinical Pathology, or return to medical research.