Annals of the American Thoracic Society

Our medical research library holds 10 studies published in Annals of the American Thoracic Society (2014–2023). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 4 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 4 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: Oxford University Press
• Published: 2013 to the present, England
• Language: English
• ISSN: 2325-6621 (electronic), 2329-6933 (print)
• Continues: Proceedings of the American Thoracic Society
• Its record in the NLM Catalog

2020s

• Global, Regional, and National Burden of Mesothelioma 1990-2019: A Systematic Analysis of the Global Burden of Disease Study 2019. J. Han, S. Park, D.K. Yon, et al. 2023;20(7):976-983. PubMed · Publisher

  Abstract

  Rationale: Mesothelioma has become a major health burden since World War II because of the use of asbestos. Although many countries have imposed bans on asbestos, there remain significant mortality and morbidity from mesothelioma because of its long latent period and aggressiveness. Also, the use of asbestos is increasing in low-income countries, potentiating risk of mesothelioma in the coming decades. Assessment of the global burden of mesothelioma is required to take proper measures against the disease. Objectives: To assess the burden of mesothelioma from 1990 to 2019 at the global, regional, and national levels and to investigate patterns according to sex, age, sociodemographic index, and risk factors. Methods: The numbers, rates, and age-standardized rates of incidence, death, and disability-adjusted life years (DALYs) of mesothelioma in 204 countries and territories from 1990 to 2019 were estimated using vital registration and cancer registry data. The relationship between sociodemographic index and age-standardized DALY rate was determined, and DALYs attributable to occupational exposure to asbestos were calculated. Results: In 2019, there were 34,511 (95% uncertainty interval [UI], 31,199 to 37,771) incident cases of mesothelioma globally, with an age-standardized rate of 0.43 per 100,000 persons (95% UI, 0.38 to 0.47), which decreased between 1990 and 2019 by -12.6% (95% UI, -21.8% to -2.3%). Mesothelioma was responsible for 29,251 (95% UI, 26,668 to 31,006) deaths in 2019, with an age-standardized rate of 0.36 deaths per 100,000 persons (95% UI, 0.33 to 0.39), which decreased between 1990 and 2019 by -9.6% (95% UI, -17.8% to -1.1%). The age-standardized incidence rate increased in central Europe between 1990 and 2019 by 46.1% (95% UI, 16.6% to 72.4%). The Netherlands, Australia, and the United Kingdom had the highest age-standardized incidence rates. Incidence rates were higher in men than in women ages 45-49 to 90-94 years, peaking at 85-89 years. Occupational exposure to asbestos contributed to 85.2% (95% UI, 82.1% to 88.1%) of DALYs. Conclusions: The global burden of mesothelioma is decreasing in terms of age-standardized incidence and mortality rates. Mesothelioma remains a substantial public health challenge in many parts of the world.

2010s

• Nonexpandable Lung: More Than Just a Call from Radiology. D. Feller-Kopman. 2019;16(10):1240-1242. Editorial · Comment PubMed · Publisher

  Summary

  This editorial commented on a study by Bibby and colleagues, published in the same issue, of nonexpandable lung (NEL) in patients with malignant pleural mesothelioma (MPM). The author first reviewed the background. Malignant pleural effusions account for more than 120,000 US hospital admissions each year. NEL can be seen in at least 30% of patients with malignant pleural effusion, but its incidence in MPM had not been described. He noted that identifying NEL matters when pleurodesis is being considered. He described the Bibby study as the first prospective evaluation of NEL in MPM. In a cohort of 229 patients, 33% had NEL, defined radiographically. NEL was an independent predictor of poor survival (hazard ratio 1.80; 95% confidence interval 1.16–2.80), independent of pleural effusion and tumor stage. Breathlessness was more common in patients with NEL than in those with effusion and expandable lung. More than half of patients with NEL were managed without pleural intervention. The author discussed possible mechanisms of breathlessness, including more negative pleural pressure reducing diaphragm efficiency. He identified as a limitation the radiologic rather than pressure-based definition of NEL, and the lack of data on volumes of fluid drained. He suggested that future studies use ultrasound and pleural pressure measurement, report causes of death, and examine whether pleurectomy might reduce deaths from respiratory failure.

  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.

• The Prevalence and Clinical Relevance of Nonexpandable Lung in Malignant Pleural Mesothelioma. A Prospective, Single-Center Cohort Study of 229 Patients. A.C. Bibby, P. Halford, D. De Fonseka, et al. 2019;16(10):1273-1279. PubMed · Publisher

  Abstract

  Rationale: Nonexpandable lung is a recognized phenomenon that can create management challenges in patients with mesothelioma. Its prevalence and clinical importance are unknown.Objectives: The aim of this study was to describe the prevalence of nonexpandable lung and to evaluate whether there was any association between nonexpandable lung and survival in a clinical cohort of patients with mesothelioma.Methods: This was a prospective, observational cohort study of patients with mesothelioma who were seen in a single center between March 1, 2008, and August 3, 2017. Baseline characteristics were collected at diagnosis. Serial chest radiographs were assessed for the presence of pleural effusions and nonexpandable lung (defined as a lack of lung expansion after pleural aspiration or drainage). Patients were followed until they died or were censored on March 14, 2019.Results: Of 229 patients, 192 (82.7%) had a pleural effusion at presentation, and nonexpandable lung was observed in 64 of these 192 patients (33.3%). Breathlessness and cough were more frequent in patients with pleural effusions, especially in those with underlying nonexpandable lung, whereas chest pain was more prevalent in patients without effusions. Patients with pleural effusions, both with and without underlying nonexpandable lung, were more likely to have epithelioid or early-stage disease and to receive chemotherapy than patients with no pleural effusion. Nonexpandable lung was an independent risk factor for short survival, with a hazard ratio for mortality of 1.80 (95% confidence interval, 1.16-2.80) compared with patients without nonexpandable lung. The presence of a pleural effusion did not appear to be associated with a worse prognosis compared with patients with an effusion (adjusted hazard ratio, 1.86; 95% confidence interval, 0.93-3.72).Conclusions: This is the first study to describe the prevalence and clinical implications of nonexpandable lung in mesothelioma. It demonstrates that nonexpandable lung is a relatively common phenomenon that is associated with significant symptomatology and shorter survival.Keywords: mesothelioma; nonexpandable lung; pleural effusion.

• Occam's Razor versus Hickam's Dictum. T.A. Newman, J.E. Takasugi, G. Matute-Bello, et al. 2017;14(11):1709-1713. Case report PubMed · Publisher

• Always Worth Another Look? Thoracic Ultrasonography before, during, and after Pleural Intervention. J.P. Corcoran, I. Psallidas, C.L. Ross, et al. 2016;13(1):118-21. Case report PubMed · Publisher

  Abstract

  A 73-year-old man with a history of occupational asbestos exposure presented with right-sided pleural thickening and effusion. Point-of-care ultrasound assessment before intervention identified the presence of a tethered lung, leading to a change in the plan for obtaining biopsies of the pleural space. Postintervention ultrasound imaging provided further diagnostic information, allowing the responsible clinicians to institute prompt emergency care with a successful outcome.

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

• Benign multicystic mesothelioma causing bilateral pneumothoraces. M. Oks, T. He, A. Palkar, et al. 2015;12(7):1106-9. Case report · Letter PubMed · Publisher

• Immunostaining in lung cancer for the clinician. Commonly used markers for differentiating primary and metastatic pulmonary tumors. J.M. Carney, A.M. Kraynie, V.L. Roggli. 2015;12(3):429-35. Review PubMed · Publisher

  Abstract

  Immunohistochemical stains have become invaluable for the diagnosis of pulmonary malignancies (both primary and metastatic), particularly given the small size of transbronchial and endobronchial biopsies and the increasing need to conserve tissue for molecular studies. There are many panels of immunostains currently available to help differentiate between common types of pulmonary malignancies. It is the purpose of this review to summarize some of the most commonly used immunostains for the distinction of primary pulmonary malignancies from one another in areas with histological overlap and for distinguishing primary pulmonary malignancies from other cancers with which they may be confused. These include differentiating between poorly differentiated adenocarcinoma and poorly differentiated squamous cell carcinoma, small cell/large cell neuroendocrine carcinoma and basaloid carcinoma, and primary and metastatic adenocarcinoma involving the lung. In addition, we address the distinction between mesothelioma and pulmonary adenocarcinoma. Pitfalls in the use of these markers are also addressed. Although not aiming to be comprehensive, this review aims to guide and influence common practice by furthering the clinician's knowledge on using immunohistochemical stains for characterization of pulmonary neoplasms. This summary of frequently used immunohistochemical stains can provide usefulness by allowing accurate characterization of pulmonary tumors, thereby allowing for conservation of tissue for additional molecular testing.

• Spontaneous Regression of Malignant Pleural Mesothelioma in a Patient with New-Onset Inflammatory Arthropathy. J.C. Moser, T. Peikert, A.C. Roden, et al. 2015;12(9):1416-7. Case report · Letter PubMed · Publisher

  Summary

  This letter described a patient whose malignant pleural mesothelioma shrank without treatment after she developed an inflammatory joint disease, and discussed what this might mean for immune-based treatment. The patient was a 75-year-old woman who had never smoked and had a history of asbestos exposure. She developed worsening shortness of breath on exertion. Two masses had previously been removed from near her navel and had been reported as mesothelial hyperplasia with atypia. CT of the chest showed a large right-sided pleural effusion and a chest wall mass. A CT-guided biopsy of the mass, together with a review of the earlier masses, was consistent with epithelioid mesothelioma. She chose not to have treatment. Two months later, imaging showed a significant reduction in the size of the tumor. In the meantime she had developed joint pain and swelling in both hands, wrists and knees. Blood tests for connective tissue disease were negative. She was diagnosed clinically with an inflammatory arthropathy, most likely remitting seronegative symmetric synovitis with pitting edema, and was given 10 mg of prednisone a day. Ongoing surveillance was recommended. She remained alive as of February 2015, more than 4 years after the first resection. The authors noted that median survival is about a year with chemotherapy. They suggested that her immune system may have helped control the cancer and that the case highlights the potential of immunotherapy for mesothelioma.

  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.

• Digital quantification of air leak to identify the location of an alveolopleural fistula. T.M. Saettele, C.A. Jimenez. 2014;11(7):1152-4. Case report PubMed · Publisher

  Abstract

  A patient developed a prolonged air leak after thoracic surgery for mesothelioma. The alveolopleural fistula was localized bronchoscopically by selective balloon occlusion of the right upper lobe segments and confirmation of decreased air leak on a digital thoracic drainage system. Five endobronchial valves were placed in the right upper lobe with resolution of the air leak.

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

  In plain English

  This case report from The University of Texas MD Anderson Cancer Center described one 62-year-old man who had surgery on the right lung and its lining (pleura) for a stage III mixed histology mesothelioma. The article did not discuss asbestos or how the cancer arose. After surgery he had a persistent air leak, which a digital chest drainage system measured at 0.1 to 0.2 L/min with suction applied at 27 mbar. On day 12 after surgery, doctors used a bronchoscope and balloon to block airways one at a time while watching the digital reading. Blocking the right upper lobe airway lowered the leak to near 0 L/min. Blocking that lobe's segments one by one did not change it. They then placed five one-way valves covering the whole right upper lobe, and the leak fell and stayed lower. The chest tube was removed 7 days later. The authors said they had used the method in two more patients. They concluded that digital leak measurement may help locate the leak's source, and noted the method needs a continuous leak and patience.

  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.

• Malignant mesothelioma and central nervous system metastases. Report of two cases, pooled analysis, and systematic review. A.C. Miller, M. Miettinen, D.S. Schrump, et al. 2014;11(7):1075-81. Case report · Systematic review PubMed · Publisher · Free full text

  Abstract

  Rationale: The incidence and patterns of metastatic disease to the central nervous system (CNS) from malignant mesothelioma are not well characterized.

  Objectives: We describe the treatment of two cases of pleural mesothelioma with CNS metastases. We also report the results of a systematic review with pooled data analysis of CNS metastases from malignant mesothelioma.

  Methods: PubMed, Scopus, EMBASE, and Web of Science were searched to identify relevant published studies. Inclusion criteria for the pooled analysis were any clinical or autopsy study in which patients had a confirmed histological diagnosis of malignant mesothelioma and CNS metastasis was identified by autopsy, clinical pathological specimen, or compelling radiographic imaging. Case reports were excluded from the pooled analysis but were incorporated into the discussion. One hundred forty-one potentially relevant references were identified. Seven studies including 655 patients were included in the pooled analysis. Ninety-seven additional cases were identified and incorporated into the discussion. A systematic review of the literature is provided with pooled data analysis.

  Measurements And Main Results: CNS involvement of malignant mesothelioma may occur by hematogenous spread or by local extension. Some cases may represent tumor dedifferentiation to a more aggressive histologic subtype. Surgery or stereotactic therapies may play a role for select patients; however, rapid recurrence has been reported.

  Conclusions: The prognostic significance of CNS disease is not well characterized. Clinicians should consider and identify CNS involvement in patients with new or evolving neurologic symptoms because early identification may allow for palliative intervention.

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