Extrathoracic lymph node metastases in malignant pleural mesothelioma

Our plain-English summary of Extrathoracic lymph node metastases in malignant pleural mesothelioma, by M. Huncharek, K. Smith (Chest, 1988).

The study

• Authors: M. Huncharek, K. Smith
• Journal: Chest
• Published: 1988;93(2):443-4
• Type of article: Letter
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter to the editor responded to a report by Kim et al of a 52-year-old man whose malignant pleural mesothelioma was diagnosed by axillary lymph node biopsy. That report included a review of 183 autopsied cases from the medical literature, in which 44 percent had tumor involvement of the hilar and mediastinal lymph nodes and only two cases (1 percent) had axillary lymph node involvement. Prompted by this, the authors reviewed 77 autopsy-confirmed cases of malignant pleural mesothelioma (44 men, 33 women) available at the Canadian Tumor Reference Center. Ages ranged from 23 to 89 years, with a mean of 61 years. Thirty-eight cases (49 percent) had documented asbestos exposure. At autopsy, 34 (44 percent) had lymph node involvement, and 31 (41 percent) of these had involvement of the hilar and mediastinal nodes. One case (1 percent) had axillary lymph node metastases, one had supraclavicular node involvement, and six had metastases to abdominal lymph nodes, so eight (10.4 percent) had extrathoracic lymph node metastases. The authors considered the 77 cases highly selected. They found that the pattern of lymph node spread closely paralleled the review by Kim et al, particularly the rarity of axillary metastases. They supported Kim and colleagues' suggestion of a prospective study to determine the true frequency of peripheral lymph node involvement in this disease.

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 was a letter to the editor responding to a case report by Kim and colleagues of a 52-year-old man whose malignant pleural mesothelioma was diagnosed by biopsy of a lymph node in the armpit (axillary node). The authors reviewed 77 autopsy-confirmed cases of malignant pleural mesothelioma held at the Canadian Tumor Reference Center: 44 men and 33 women, aged 23 to 89 (mean 61). Thirty-eight (49 percent) had documented asbestos exposure. The letter did not name the type of asbestos. At autopsy, 34 (44 percent) had cancer in lymph nodes, and 31 (41 percent) had it in the hilar and mediastinal nodes. One case (1 percent) had spread to axillary nodes, one to supraclavicular nodes, and six to abdominal nodes. In total, eight (10.4 percent) had spread to lymph nodes outside the chest. The authors considered these cases highly selected. They wrote that the pattern closely paralleled Kim and colleagues' literature review, especially in how rarely axillary nodes were involved. They supported Kim and colleagues' call for a prospective study of how often peripheral lymph nodes are involved.

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: Letter to the editor reporting a review of autopsy-confirmed case records (case series)
• Who was studied: 77 autopsy-confirmed cases of malignant pleural mesothelioma (44 men, 33 women, aged 23 to 89, mean 61 years) at the Canadian Tumor Reference Center; dates not given
• Exposure: Documented asbestos exposure in 38 of the 77 cases (49 percent); fiber type, products and jobs not given
• Main results:
  • 34 of the 77 cases (44 percent) had lymph node involvement at autopsy
  • 31 cases (41 percent) had cancer in the hilar and mediastinal lymph nodes
  • One case (1 percent) had metastatic disease in the axillary lymph nodes, and one further case had supraclavicular node involvement
  • Eight of the 77 cases (10.4 percent) had lymph node metastases outside the chest: one axillary, one supraclavicular and six abdominal
• The authors' conclusion: The authors concluded that their data gave further evidence of a gap between the observed and expected frequency of axillary lymph node involvement in malignant pleural mesothelioma. They supported Kim and colleagues' suggestion of a prospective study to find the true frequency of peripheral lymph node involvement.
• Limitations the authors state:
  • The authors considered the 77 cases highly selected

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Biopsy, Mediastinal Lymph Nodes, Autopsy, Asbestos Exposure.

Related studies

• Cytokeratin 19 expression in primary thoracic tumors and lymph node metastases — K. Masai, K. Nakagawa, et al. (2014)
• Fine-needle aspiration biopsy of axillary lymph nodes — S. Jaffer, M. Zakowski (2002)
• Lymph node metastases in diffuse malignant peritoneal mesothelioma — D. Baratti, S. Kusamura, et al. (2010)
• Malignant pleural mesothelioma initially diagnosed on cervical lymph node biopsy — S. Ogata, S. Hiroi, et al. (2009)
• Peritoneal malignant mesothelioma metastatic to supraclavicular lymph nodes — S. Zannella, M.A. Testi, et al. (2014)
• Characteristics of asbestos concentration in lung as compared to asbestos concentration in various levels of lymph nodes that collect drainage from the lung — R.F. Dodson, S. Shepherd, et al. (2007)

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