Excessive lipid-phagocytosis of neutrophils in a patient with mesothelioma

Our plain-English summary of Excessive lipid-phagocytosis of neutrophils in a patient with mesothelioma, by C. Morales-Indiano, M. Carbonell Prat, E. Castellà Fernández, et al (Diagnostic Cytopathology, 2015).

The study

• Authors: C. Morales-Indiano, M. Carbonell Prat, E. Castellà Fernández, L. Arenillas Rocha, L. Florensa
• Journal: Diagnostic Cytopathology
• Published: 2015;43(10):830-2
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This article was a case report about one patient. A 56-year-old man diagnosed two years earlier with stage IV peritoneal mesothelioma was admitted because of increasing breathing difficulties. A chest X-ray showed fluid around both lungs (a bilateral pleural effusion), worse on the left. A small amount of milky fluid was drawn off. The fluid contained 2,907 mg/dL of triglycerides and 136 mg/dL of total cholesterol, which the authors called compatible with chylothorax, a buildup of lymphatic fluid (chyle) in the chest. Of the white cells in the fluid, 53% were neutrophils. Under the microscope, these neutrophils held many small round inclusions that stained positive with Oil Red O, a stain for fat. A CT scan showed enlarged lymph nodes in the middle of the chest, which were considered the cause of the chylothorax. The patient was given a special diet and octreotide but deteriorated and died within a week. The authors concluded that fat-filled neutrophils staining with Oil Red O can help in the early diagnosis of chylothorax. The article does not mention asbestos.

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 (Images in Cytology)
• Who was studied: one 56-year-old man with stage IV peritoneal mesothelioma diagnosed 2 years earlier, admitted for increasing breathing difficulties; hospitals in Badalona and Barcelona, Spain
• Exposure: not reported; the article does not mention asbestos or any other exposure
• Main results:
  • A diagnostic thoracocentesis (needle drainage of chest fluid) obtained a small amount of milky pleural fluid
  • The patient's pleural fluid had triglycerides of 2,907 mg/dL and total cholesterol of 136 mg/dL, which the authors described as compatible with chylothorax
  • The patient's fluid contained 2,540 red blood cells/mL and 1,450 leukocytes/mL. The white-cell differential was 53% neutrophils, 15% lymphocytes, 30% macrophages and 2% mesothelial cells
  • The patient's neutrophils contained abundant small white spherical inclusions that were positive for Oil Red O, indicating lipid
  • A CT scan showed mediastinal lymphadenopathy (enlarged lymph nodes in the middle of the chest), which was considered the cause of the chylothorax
  • The patient was treated with a diet rich in intermediate chain triglycerides and octreotide 50 mcg every 8 hours, but deteriorated and died within a week
• The authors' conclusion: The authors concluded that abundant small spherical inclusions in neutrophils that stain positive for Oil Red O can help in the early diagnosis of chylothorax

Topics

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

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

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