Localized malignant lymphohistiocytoid pleural mesothelioma

Our plain-English summary of Localized malignant lymphohistiocytoid pleural mesothelioma, by A. Ouazzani, B. Rondelet, Y. Sokolow, et al (Acta Chirurgica Belgica, 2011).

The study

• Authors: A. Ouazzani, B. Rondelet, Y. Sokolow, M. Ruiz Patino, M. Remmelink, M. Cappello
• Journal: Acta Chirurgica Belgica
• Published: 2011;111(1):38-43
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report a case of a 42-year-old man with a right pleural mesothelioma. This neoplasm has 3 rare features. Firstly, it was a localized form: suspected by imaging, visualized by video-assisted thoracoscopy, at the time of the curative-thoracotomy and confirmed by the pathological analysis. The second characteristic is its histological type: "malignant lymphohistiocytoid mesothelioma". This rare subtype has been reported in only 4 papers. Third, after pleuro-pneumonectomy, our patient is alive after 6 years and 5 months postoperatively without any sign of recurrence. Only one case with a long follow-up has been reported but with recurrence at 5 years postoperatively.

In plain English

This article is a case report about one 42-year-old man with a localized malignant mesothelioma of the pleura (the lining of the chest) of a rare type called lymphohistiocytoid. He was admitted in May 2000 with pain in the right upper abdomen and flank, and his illness was at first misdiagnosed as biliary colic and a bowel disorder. He had no known asbestos exposure. A CT scan later found a mass in the right pleural recess, and a needle biopsy showed malignant mesothelioma. Surgeons removed the tumour, the affected rib, the right lung and the pleura in one operation (an extrapleural pleuro-pneumonectomy). An asbestos analysis of the removed lung found no evidence of asbestos exposure. Radiotherapy was planned at 54 Gy but was stopped at 33 Gy because his condition worsened. He was alive with no sign of recurrence 6 years and 5 months after surgery. The authors described this as the second reported case of its kind. They concluded that localized pleural mesothelioma should be considered a separate clinical entity from diffuse mesothelioma. The report describes one patient only.

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 (single patient)
• Who was studied: One 42-year-old man admitted in May 2000 to Erasme University Hospital, Brussels, Belgium, with right upper abdominal and flank pain
• Exposure: The patient had no known asbestos exposure, and a quantitative asbestos analysis of the removed lung found no evidence of asbestos exposure
• Main results:
  • A CT scan found a mass in the right pleural recess
  • Fine needle aspiration and biopsy showed the parietal pleura invaded by malignant mesothelioma
  • The tumour and the involved rib were removed in one piece, together with a right extrapleural pleuro-pneumonectomy
  • The tumour measured 10 by 8.5 by 2 cm (the multiplication signs are missing in the text)
  • Tumour cells tested positive for pan-cytokeratin (AE1/AE3), cytokeratin 5 and 6, and calretinin
  • Adjuvant radiotherapy was stopped at 33 Gy, out of a planned total of 54 Gy, because the patient's condition worsened
  • The patient was alive without recurrence 6 years and 5 months after the operation
  • The authors described this as the second reported case of localized pleural malignant mesothelioma of the lymphohistiocytoid subtype
• The authors' conclusion: The authors concluded that localized pleural malignant mesothelioma should be considered a clinical entity distinct from diffuse malignant mesothelioma

Topics

Medical terms in this study, explained in our Lexicon: Lymphohistiocytoid, Pleural Mesothelioma, Neoplasm, Thoracoscopy, Thoracotomy, Mesothelioma, Pneumonectomy.

Related studies

• Minute localized malignant pleural mesothelioma coexisting with multiple adenocarcinomas — R. Maeda, N. Isowa, et al. (2010)
• Benign localized fibrous tumor of the pleura: report of 25 new cases — S. Enon, D. Kilic, et al. (2012)
• Localized malignant pleural mesothelioma — T. Nakano, R. Hamanaka, et al. (2012)
• Localized biphasic malignant peritoneal mesothelioma presenting as a rectal tumor — K. Saisho, S. Fujiwara, et al. (2020)
• Huge malignant solitary fibrous tumor of the pleura — W.A. Arab, D. Lamoth, et al. (2012)
• Localized mesotheliomas of the pleura. The pathologic evaluation of 18 cases — E.A. Foster, L.V. Ackerman (1960)

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