Isolated pancreatic metastasis from a malignant pleural mesothelioma diagnosed using endoscopic ultrasonography-guided fine needle aspiration biopsy

Our plain-English summary of Isolated pancreatic metastasis from a malignant pleural mesothelioma diagnosed using endoscopic ultrasonography-guided fine needle aspiration biopsy, by Y. Ishikawa-Kakiya, H. Maruyama, K. Tanoue, et al (Hepatobiliary & Pancreatic Diseases International, 2022).

The study

• Authors: Y. Ishikawa-Kakiya, H. Maruyama, K. Tanoue, S. Fukunaga, Y. Nagami, Y. Fujiwara
• Journal: Hepatobiliary & Pancreatic Diseases International
• Published: 2022;21(2):196-198
• Type of article: Letter
• Read it: PubMed · Publisher

In plain English

This letter to the editor was a case report describing one patient. The patient was a 66-year-old man who had worked in a shipyard, where he had been exposed to asbestos for 10 years; the article did not name the fiber type. He had earlier been diagnosed with epithelioid malignant pleural mesothelioma, treated with chemotherapy and surgery, and treated again after the cancer returned in the right pleura and lymph nodes. Scans then showed a 5 mm low-density area in the body of the pancreas, which grew to 12 mm within 3 months. Cells were sampled with a needle guided by endoscopic ultrasonography (EUS-FNAB). Their staining pattern (positive for CK7, D2-40, WT-1 and calretinin; negative for CA19-9 and CD20) led the authors to diagnose a stage IV pancreatic metastasis from the pleural mesothelioma. After vinorelbine chemotherapy, the patient was reported to be in good form 5 years after the initial diagnosis. The authors called this the first report of EUS-FNAB used to diagnose an isolated pancreatic metastasis from malignant pleural mesothelioma, and concluded that EUS and EUS-FNAB are useful for this diagnosis.

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 (letter to the editor) of a single patient
• Who was studied: One 66-year-old man who had worked in a shipyard, with a smoking history of 20 cigarettes per day for 5 years; reported by the Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan
• Exposure: Occupational asbestos exposure in a shipyard for 10 years; fiber type not stated
• Main results:
  • The patient had previously been diagnosed with epithelioid malignant pleural mesothelioma, treated with neoadjuvant cisplatin with pemetrexed followed by pleurectomy/decortication, and later with further chemotherapy after right pleural recurrence and lymph node metastasis
  • Contrast-enhanced CT showed a 5 mm low-density area in the pancreatic body 9 months after treatment, which increased to 12 mm in 3 months
  • PET scan showed weak uptake in the pancreatic lesion with a standardized uptake value of 3.19
  • Endoscopic ultrasonography showed the pancreatic lesion as a low-echoic lesion with a clear and regular border
  • Immunohistochemistry of the EUS-FNAB sample was negative for CA19-9 and CD20 and positive for CK7, D2-40, WT-1 and calretinin
  • The lesion was diagnosed as pancreatic metastasis from malignant pleural mesothelioma in stage IV
  • After chemotherapy with vinorelbine, the patient was reported to remain in good form 5 years after the initial diagnosis
• The authors' conclusion: The authors concluded that pancreatic metastasis from malignant pleural mesothelioma is rare but should be considered, and that EUS and EUS-FNAB are useful for its diagnosis; they described this as the first report of EUS-FNAB used to diagnose isolated pancreatic metastasis from malignant pleural mesothelioma

Topics

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

Medical terms in this study, explained in our Lexicon: Metastasis, Pleural Mesothelioma, Biopsy.

Related studies

• Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions — I. Skovgaard Christiansen, J.C. Kuijvenhoven, et al. (2019)
• Endoscopic ultrasound-guided fine needle aspiration of a pericardial mass — P. Somani, M. Sharma, et al. (2016)
• Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma — M. Sperandeo, L. Dimitri, et al. (2014)
• "Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) — F. Lococo, G. Rossi, et al. (2014)
• Endobronchial ultrasound-guided transbronchial needle aspiration with the flexible 19-gauge needle — R. Trisolini, F. Natali, et al. (2018)
• Thoracic splenosis diagnosed by fine-needle aspiration cytology: a case report — S. Syed, P. Zaharopoulos (2001)

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