Endoscopic ultrasound-guided fine needle aspiration of a pericardial mass

Our plain-English summary of Endoscopic ultrasound-guided fine needle aspiration of a pericardial mass, by P. Somani, M. Sharma, A. Patil, et al (Endoscopy, 2016).

The study

• Authors: P. Somani, M. Sharma, A. Patil, A. Kumar
• Journal: Endoscopy
• Published: 2016;48 Suppl 1 UCTN:E45-6
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This report described the use of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) through the esophagus to diagnose a mass on the pericardium. The authors noted that primary malignant pericardial mesothelioma is extremely rare, with a reported prevalence of 0.0022% in autopsy series and only about 350 cases reported in the literature. They also noted that it is diagnosed before death in only 10%–20% of cases, partly because cytology of pericardial fluid is often negative. The patient was a 55-year-old man seen at a gastroenterology department in India. He had progressive shortness of breath on exertion over the preceding 4 months. Computed tomography of the chest showed a well-defined, heterogeneously enhancing lesion measuring 2.1×1.8×1.8 cm attached to the posterior pericardium, together with a pericardial effusion. Fluid obtained by pericardiocentesis was negative for malignant cells and tuberculosis. To obtain a tissue diagnosis, EUS-guided transesophageal FNA was performed in the endoscopy room after the cardiology and cardiovascular surgical teams had been alerted. EUS showed a mixed echogenic pericardial mass with an effusion, and the mass was punctured with a 22-gauge needle in five passes. No arrhythmias or other adverse events occurred during the following 24 hours. May–Grünwald–Giemsa staining and immunocytochemistry confirmed pericardial mesothelioma. The patient died 2 weeks after diagnosis. The authors cited earlier reports that transesophageal EUS-guided access to the heart has been performed safely and that EUS-guided FNA has been used for atrial and pericardial tumors. The report did not mention asbestos exposure.

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 was a short case report in the journal's Cases and Techniques Library. It described one 55-year-old man whose shortness of breath on exertion had worsened over the preceding 4 months. A CT scan of his chest showed a lesion measuring 2.1×1.8×1.8 cm attached to the back of the pericardium (the sac around the heart), along with fluid around the heart. Fluid drained from the pericardium tested negative for cancer cells and for tuberculosis. To obtain a tissue sample, an ultrasound endoscope was passed into the esophagus and the mass was sampled with a 22-gauge needle, using five passes. No heart rhythm problems or other adverse events occurred during the following 24 hours. Staining and immunocytochemical tests on the sample confirmed pericardial mesothelioma. The patient died 2 weeks after diagnosis. The article did not mention asbestos, any other exposure, or the patient's work history. The figures in the introduction on how rare this disease is came from earlier published studies, not from this case.

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 (Cases and Techniques Library) of a single patient
• Who was studied: One 55-year-old man with progressive shortness of breath on exertion over 4 months. The article does not state when he was seen. The authors are from the Department of Gastroenterology, Jaswant Rai Speciality Hospital, India.
• Exposure: Not reported. The article does not mention asbestos, any other exposure, or the patient's occupation.
• Main results:
  • In the patient, CT of the chest showed a well-defined lesion of 2.1×1.8×1.8 cm attached to the posterior pericardium, with a pericardial effusion (fluid around the heart).
  • In the patient, pericardial fluid obtained by pericardiocentesis was negative for malignant cells and for tuberculosis.
  • The mass was sampled through the esophagus under endoscopic ultrasound guidance with a 22-gauge needle, using five passes.
  • In the patient, no arrhythmias or other adverse events occurred during the 24 hours after the procedure.
  • In the patient, May–Grünwald–Giemsa staining and immunocytochemistry of the sample confirmed pericardial mesothelioma.
  • The patient died 2 weeks after diagnosis.
• The authors' conclusion: The article does not state a separate conclusion of its own.

Topics

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

Medical terms in this study, explained in our Lexicon: Ultrasound, Pericardial, Pericardium, Pericardial Mesothelioma, Autopsy, Cytology, Pericardial Effusion, Pericardiocentesis.

Related studies

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• Endobronchial ultrasound-guided transbronchial needle aspiration in a patient with pericardial mesothelioma — H. Ashinuma, M. Shingyoji, et al. (2015)
• Isolated pancreatic metastasis from a malignant pleural mesothelioma diagnosed using endoscopic ultrasonography-guided fine needle aspiration biopsy — Y. Ishikawa-Kakiya, H. Maruyama, et al. (2022)
• Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma — M. Sperandeo, L. Dimitri, et al. (2014)
• The role of endobronchial ultrasound-guided fine needle aspiration in the diagnosis of pleural mesothelioma — M.R. Ghigna, A. Crutu, et al. (2016)
• Endobronchial ultrasound-guided transbronchial needle aspiration with the flexible 19-gauge needle — R. Trisolini, F. Natali, et al. (2018)

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