Diffuse Pleural Myeloid Sarcoma Mimicking Malignant Mesothelioma

Our plain-English summary of Diffuse Pleural Myeloid Sarcoma Mimicking Malignant Mesothelioma, by A. Dong, C. Bai, C. Zuo (Journal of Thoracic Oncology, 2016).

The study

• Authors: A. Dong, C. Bai, C. Zuo
• Journal: Journal of Thoracic Oncology
• Published: 2016;11(4):603-5
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This "Image of the Month" report described a 23-year-old man referred to Changhai Hospital, Shanghai, China, with a 2-month history of cough and chest discomfort. Contrast-enhanced chest computed tomography (CT) showed an ill-circumscribed mediastinal tumor encasing the vessels and diffuse thickening of the right pleura with effusion. Fluorine 18-labeled fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed increased FDG uptake by the mediastinal tumor and the thickened right pleura, with large pericardial and right pleural effusions. Right pleural malignant mesothelioma with mediastinal involvement was suspected. CT-guided biopsy of the mediastinal tumor showed tumor cells positive for vimentin, leukosialin, myeloperoxidase and leukocyte common antigen, consistent with myeloid sarcoma. The authors explained that myeloid sarcoma is an uncommon localized tumor formed by primitive myeloid cells outside the bone marrow. It may precede, follow or occur without systemic acute myeloid leukemia. In adults it most often involves the skin, central nervous system, bone and lymph nodes. They noted that FDG PET/CT is useful for detection, staging and assessing treatment response, and that diffuse pleural and mediastinal involvement was unusual for this tumor. They concluded that, although rare, myeloid sarcoma should be considered in the differential diagnosis of diffuse pleural thickening with abnormal FDG uptake, along with malignant mesothelioma and tuberculosis.

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 is a short 'Image of the Month' case report about one patient at Changhai Hospital in Shanghai, China. A 23-year-old man came to the hospital after two months of cough and chest discomfort. A chest CT scan showed a poorly defined tumor in the mediastinum (the central part of the chest) wrapped around blood vessels. It also showed widespread thickening of the right pleura (the lining around the right lung) with fluid. A PET/CT scan showed increased uptake of the tracer FDG in the mediastinal tumor and the thickened right pleura, plus large fluid collections around the heart and the right lung. The doctors suspected malignant mesothelioma of the right pleura reaching into the mediastinum. However, a CT-guided biopsy of the mediastinal tumor showed tumor cells with markers consistent with myeloid sarcoma. The authors described this spread to the pleura and mediastinum as unusual for myeloid sarcoma. They concluded that, although rare, it should be considered alongside malignant mesothelioma and tuberculosis when diffuse pleural thickening is seen together with abnormal FDG uptake. The article does not mention asbestos, and it does not report this patient's treatment or outcome.

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 (single-patient 'Image of the Month' imaging report)
• Who was studied: one 23-year-old male patient referred to Changhai Hospital, Shanghai, People's Republic of China, with a 2-month history of cough and chest discomfort
• Exposure: Not reported; the article does not mention asbestos or any other exposure
• Main results:
  • Chest enhanced CT showed a poorly defined tumor of the mediastinum encasing the vessels and diffuse thickening of the right pleura with effusion
  • FDG PET/CT showed increased FDG uptake by the mediastinal tumor and the thickened right pleura
  • The patient had large pericardial and right pleural effusions
  • Right pleural malignant mesothelioma with mediastinal involvement was initially suspected
  • A CT-guided biopsy of the mediastinal tumor showed tumor cells positive for vimentin, leukosialin, myeloperoxidase, and leukocyte common antigen, consistent with myeloid sarcoma
• The authors' conclusion: The authors stated that the diffuse pleural and mediastinal involvement in this case was unusual for myeloid sarcoma. They concluded that, although rare, myeloid sarcoma should be considered in the differential diagnosis of diffuse pleural thickening and abnormal FDG accumulation, along with malignant and nonmalignant processes including malignant mesothelioma and tuberculosis.

Topics

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

Medical terms in this study, explained in our Lexicon: Sarcoma, Malignant Mesothelioma, Pleura, Pericardial, Pleural Effusion, Biopsy, Staging, Differential Diagnosis.

Related studies

• Mediastinal and pleuropulmonary myeloid sarcoma with HBME1 and podoplanin expression. A diagnostic pitfall — D. Suárez-Vilela, F.M. Izquierdo (2020)
• Multiple primary hepatic malignant mesotheliomas mimicking cystadenocarcinomas on enhanced CT and FDG PET/CT — A. Dong, H. Dong, et al. (2014)
• Whole-Body MRI: Comparison of Its Capability for TNM Staging of Malignant Pleural Mesothelioma With That of Coregistered PET/MRI, Integrated FDG PET/CT, and Conventional Imaging — Y. Ohno, M. Yui, et al. (2019)
• Present and future roles of FDG-PET/CT imaging in the management of malignant pleural mesothelioma — K. Kitajima, H. Doi, et al. (2016)
• 18F-FDG-PET/CT of peritoneal tumors: a pictorial essay — J. Dubreuil, F. Giammarile, et al. (2017)
• 18F-Fluorodeoxyglucose PET/CT and dynamic contrast-enhanced MRI as imaging biomarkers in malignant pleural mesothelioma — D.O. Hall, C.E. Hooper, et al. (2018)

Browse more research in Journal of Thoracic Oncology, or return to medical research.