Endobronchial Diagnosis of a Malignant Mesothelioma

Our plain-English summary of Endobronchial Diagnosis of a Malignant Mesothelioma, by H.S. Yap, S. Klebe, A. Rose (Journal of Bronchology & Interventional Pulmonology, 2016).

The study

• Authors: H.S. Yap, S. Klebe, A. Rose
• Journal: Journal of Bronchology & Interventional Pulmonology
• Published: 2016;23(3):e30-2
• Type of article: Case report, Letter
• Read it: PubMed · Publisher

In plain English

This letter to the editor, from authors at Flinders Medical Centre and Flinders University in South Australia, is a case report about one patient. A 64-year-old man with a history of asbestos exposure, who did not smoke, had a dry cough for four months, with chest tightness and shortness of breath. The type of asbestos and how he was exposed were not reported. Scans showed fluid around the right lung and pleural plaques. Fluid drawn from his chest contained no cancer cells. Biopsies taken during keyhole chest surgery (VATS) showed benign asbestos-related fibrinous pleuritis, a non-cancerous inflammation. Six months later his symptoms persisted, the pleural lining had thickened further, and lymph nodes in the middle of his chest were enlarged. A camera examination of the airways (bronchoscopy) with endobronchial ultrasound found infiltration of the airway lining in the right lower lobe. Brushings, a needle sample from a lymph node and an airway biopsy confirmed malignant epithelioid mesothelioma. He received one cycle of chemotherapy, tolerated it poorly, and was then given palliative care. The authors concluded that bronchoscopy and endobronchial ultrasound can confirm mesothelioma in select cases.

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) describing one patient
• Who was studied: One 64-year-old man with a history of asbestos exposure, a nonsmoker. The authors are based at Flinders Medical Centre and Flinders University, South Australia. Dates are not given.
• Exposure: A background history of asbestos exposure. No fiber type, job, product or dose is reported.
• Main results:
  • The patient was a nonsmoker. A CT scan of the chest showed pleural plaques, partial collapse of the right lower lobe and a pleural effusion.
  • A 500 mL pleural fluid sample was negative for malignant cells and on microbiologic studies.
  • Biopsies from video-assisted thoracoscopic surgery (VATS) showed benign asbestos-related fibrinous pleuritis.
  • Six months after VATS the patient's symptoms persisted. There was progressive pleural thickening and significant mediastinal lymph node enlargement.
  • Bronchoscopy with endobronchial ultrasound showed mucosal infiltration in the right lower lobe.
  • Cells from the lymph node needle sample were positive for the mesothelial-related markers calretinin, WT1 and CK5/6. They were negative for the carcinoma-related markers TTF-1, BerEP4 and CD15.
  • The bronchial biopsy showed invasive malignant epithelioid mesothelial cells. Mesothelioma was confirmed on the endobronchial biopsy, the brushing and the EBUS-guided needle aspirate.
  • The patient had one cycle of palliative chemotherapy with cisplatin and pemetrexed, tolerated it poorly, and was then managed conservatively with palliative intent.
• The authors' conclusion: The authors concluded that bronchoscopy and endobronchial ultrasound can confirm a diagnosis of malignant mesothelioma in select cases.

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: Malignant Mesothelioma.

Related studies

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• Pleural mesothelioma: When echo-endoscopy (EUS-B-FNA) leads to diagnosis in a minimally invasive way — R. Piro, M. Fontana, et al. (2021)
• Mesothelioma--VATS biopsy and lung mobilization improves diagnosis and palliation — M.W. Grossebner, A.A. Arifi, et al. (1999)
• Outcome and prognostic factors of pleural mesothelioma after surgical diagnosis and/or pleurodesis — M. Baud, S. Strano, et al. (2013)
• The role of endobronchial ultrasound-guided fine needle aspiration in the diagnosis of pleural mesothelioma — M.R. Ghigna, A. Crutu, et al. (2016)

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