Intrathoracic mesothelioma

Our plain-English summary of Intrathoracic mesothelioma, by W.B. Hutchinson, M.J. Friedenberg (Radiology, 1963).

The study

• Authors: W.B. Hutchinson, M.J. Friedenberg
• Journal: Radiology
• Published: 1963;80:937-45
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003298).

Abstract

The clinical, radiographic, and pathologic findings in 20 cases of intrathoracic mesothelioma are reported. Benign mesotheliomas occasionally contain calcification, are rarely associated with pleural effusion, and never destroy or erode bone. They vary considerably in size, the large ones often displacing the heart and mediastinum. Malignant mesothelioma is characterized by thickening and fixation of the involved serosal surface and in our series was not associated with significant shift of the heart or mediastinum in spite of the great propensity for rapid re-accumulation of fluid following thoracentesis or pericardiocentesis.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article reported 20 pathologically proved cases of intrathoracic mesothelioma, arising from the pleura or pericardium, seen during the twelve-year period 1950-1961. Nine of these had been reported earlier by other authors. It described the patients' clinical, X-ray and pathology findings and did not discuss asbestos or any other cause. Seventeen cases were localized mesotheliomas (15 benign fibrous, 2 papillary) and 3 were diffuse malignant mesotheliomas. There were 11 males and 9 females, aged nineteen to seventy-six. Seventeen of the 20 had symptoms, most often chest pain, weight loss, shortness of breath and joint pain. Among the 17 localized cases, only 2 showed pleural effusion on X-ray and 2 contained calcification. Fourteen were followed for one to ten years after surgery, with no illness or death attributed to the tumor. All 3 patients with diffuse malignant mesothelioma died within one year of surgery. The authors concluded that mesothelioma should be strongly considered in a patient with pulmonary osteoarthropathy and a pleura-based chest mass on X-ray.

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 series (retrospective review of clinical, radiographic and pathologic findings)
• Who was studied: 20 patients with pathologically proved intrathoracic mesothelioma of the pleura or pericardium, seen 1950-1961 (9 previously reported by Benoit and Ackerman and by Blount); 11 males and 9 females, aged nineteen to seventy-six, 80 per cent over forty
• Exposure: Not reported; the article does not mention asbestos or any other exposure
• Main results:
  • Of the 20 cases, 17 were localized mesotheliomas (15 benign fibrous type, 2 papillary type) and 3 were diffuse malignant mesotheliomas (2 of them called papillary)
  • 17 of the 20 patients had symptoms; the most frequent were chest pain, weight loss, dyspnea and joint pain
  • Of the 17 patients with localized mesothelioma, only 2 had radiographic evidence of pleural effusion, one of them with complicating pneumonia that could have caused it
  • 4 of the 17 localized cases showed massive opacification of the lower two-thirds of one side of the chest, and in 2 of these the heart and mediastinum were shifted to the opposite side
  • Calcification was found in 2 localized mesotheliomas
  • 14 of the 17 localized-mesothelioma patients were followed for one to ten years after surgery, and none had morbidity or mortality attributed to the mesothelioma
  • All 3 patients with diffuse malignant mesothelioma died within one year of surgery
  • In the diffuse malignant cases, there was no significant shift of the heart or mediastinum despite a great tendency for fluid to re-accumulate rapidly after thoracentesis or pericardiocentesis
• The authors' conclusion: The authors concluded that mesothelioma occurs more often than may be realized. They said it should be strongly considered in a patient with pulmonary osteoarthropathy and a chest density that looks on X-ray like a pleura-based tumor. They described localized fibrous mesothelioma as benign and curable by surgical excision, and diffuse mesothelioma as extremely malignant.
• Limitations the authors state:
  • Of the 5 patients with signs or symptoms of osteoarthropathy, X-rays of the extremities were made in only 2
  • Films for one localized case were not available; it was included on the basis of written radiology reports

Topics

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

Medical terms in this study, explained in our Lexicon: Intrathoracic, Mesothelioma, Pleural Effusion, Mediastinum, Malignant Mesothelioma, Serosal Surface, Thoracentesis, Pericardiocentesis.

Related studies

• Asbestosis and primary intrathoracic neoplasms — W.D. Buchanan (1965)
• Extrapleural and cardiophrenic lymph nodes: prevalence, clinical significance and diagnostic value — B. Feragalli, C. Mantini, et al. (2014)
• COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study — M.C. Garassino, J.G. Whisenant, et al. (2020)
• Clinical development of TargomiRs, a miRNA mimic-based treatment for patients with recurrent thoracic cancer — G. Reid, S.C. Kao, et al. (2016)
• Loss of expression of BAP1 predicts longer survival in mesothelioma — M. Farzin, C.W. Toon, et al. (2015)
• Radiation therapy in the management of patients with mesothelioma — W. Gordon, K.H. Antman, et al. (1982)

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