Interleukin-5-producing malignant pleural mesothelioma with eosinophilic pleural effusion

Our plain-English summary of Interleukin-5-producing malignant pleural mesothelioma with eosinophilic pleural effusion, by E. Takeuchi, N. Takahashi, S. Morizumi, et al (Thoracic Cancer, 2020).

The study

• Authors: E. Takeuchi, N. Takahashi, S. Morizumi, H. Tamiya, H. Matsuoka, N. Kuroda, K. Yorita
• Journal: Thoracic Cancer
• Published: 2020;11(10):3043-3046
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant tumors are often associated with eosinophilic pleural effusion. Here, we encountered a case of interleukin-5 (IL-5)-producing malignant pleural mesothelioma with eosinophilic pleural effusion. The patient was a 50-year-old male. He had a history of a cough for several weeks and had visited a local doctor. Left pleural effusion was noted, and the patient was referred to our hospital. He was diagnosed with malignant pleural mesothelioma by pleural biopsy, with eosinophilic pleural effusion. IL-5 in the pleural effusion increased, and tumor cells were IL-5-positive by immunostaining. There have been few reports of IL-5-producing tumors, and this is the first report of IL-5-producing malignant pleural mesothelioma. Host-tumor cell interactions cause eosinophilic pleural effusion. In patients with eosinophilic pleural effusion, malignant pleural effusion should be considered. It is necessary to clarify the pathophysiology of malignant tumors and eosinophils.

© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

In plain English

This case report described a 50-year-old man found, after several weeks of cough and sputum, to have fluid around his left lung (pleural effusion). He had worked as a painter, and asbestos exposure was considered likely. He had smoked two packets of cigarettes a day for 35 years. Eosinophils, a type of white blood cell, were 47% of cells in the fluid but 3% in his blood. Cell tests, a genetic test and a biopsy showed biphasic malignant pleural mesothelioma (70% epithelioid cells); further examination including PET/CT placed it at clinical stage III. Interleukin-5 (IL-5), a signalling protein linked to eosinophils, measured 23.5 pg/mL in the fluid and 3.9 pg/mL or less in blood. Tumor tissue stained positive for IL-5, suggesting to the authors that the tumor produced it. After three cycles of cisplatin and pemetrexed his disease progressed; he was transferred to a hospice and died about a year later. The authors called this the first report of IL-5-producing malignant pleural mesothelioma and concluded that malignant pleural effusion should be considered in patients with eosinophilic pleural effusion.

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
• Who was studied: One 50-year-old man with cough and sputum for several weeks, referred to the authors' hospital (the authors are based at hospitals in Japan); dates not given
• Exposure: Worked as a painter; the authors state asbestos exposure was considered likely (no fiber type or dose given). He also smoked two packets of cigarettes per day for 35 years.
• Main results:
  • In the patient's pleural fluid, 47% of cells were eosinophils (4% neutrophils, 36% lymphocytes, 10% monocytes)
  • Eosinophils were 3% of white blood cells in the patient's blood
  • A genetic test on the fluid found loss of both p16 gene signals in 45% of tumor cells
  • Biopsy diagnosis: biphasic malignant pleural mesothelioma with 70% epithelioid cells and 30% sarcomatoid cells
  • After further examination including FDG-PET/CT, the patient was clinically staged as cT3N2M0 stage III
  • IL-5 in the patient's pleural fluid was 23.5 pg/mL
  • IL-5 in the patient's blood was 3.9 pg/mL or less (GM-CSF 8 pg/mL or less)
  • The patient's tumor tissue stained positive for IL-5, which the authors said suggested IL-5 production by the mesothelioma cells
  • After three monthly cycles of chemotherapy (cisplatin and pemetrexed) his condition progressed
  • He was transferred to a hospice and died about a year later
• The authors' conclusion: The authors concluded that this was the first report of malignant pleural mesothelioma producing IL-5, and that malignant pleural effusion should be considered in patients with eosinophilic pleural effusion.

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, Eosinophilic, Pleural Effusion, Pleural Biopsy.

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• Pathogenesis of the eosinophilic pleural effusions — I. Kalomenidis, R.W. Light (2004)
• Eosinophilic pleural effusions — I. Kalomenidis, R.W. Light (2003)
• Progress report on the palliative therapy of 100 patients with neoplastic effusions by intracavitary low-dose interleukin-2 — P. Lissoni, M. Mandalà, et al. (2001)
• Intrapleural interleukin-2 induces nitric oxide production in pleural effusions from malignant mesothelioma: a possible mechanism of interleukin-2-mediated cytotoxicity? — C. Porta, V. Rizzo, et al. (2002)

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