Localized malignant myxoid anaplastic mesothelioma of the pericardium

Our plain-English summary of Localized malignant myxoid anaplastic mesothelioma of the pericardium, by G.Z. Yang, J. Li, H.Y. Ding (Journal of Clinical Medicine Research, 2009).

The study

• Authors: G.Z. Yang, J. Li, H.Y. Ding
• Journal: Journal of Clinical Medicine Research
• Published: 2009;1(2):115-8
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Unlabelled: Primary malignant mesothelioma of the pericardium is a rare cardiac neoplasm. Most are diffuse and have poor prognosis with median survival of six months. In the paper, we describe a young male patient having no exposure history of asbestos with localized malignant myxoid mesothelioma of the pericardium. The tumor displayed significant myxoid change in stroma, and anaplastic cytology, including pleomorphy, poor cohesion, prominent nuclei, with high mitoses, which led to difficulty in diagnosis. The tumor showed typical immunohistochemical phenotypes of mesothelioma, positive for WT-1, calretinin and CK5/6. Ki-67 labeling index was about 50% in general and nearly 80% in the most active areas. The patient showed better outcome. The report suggests the diagnosis of myxoid mesothelioma is supposed to rely on clinical data, and immunohistochemistry is assumed to be for differentiation.

Keywords: Myxoid mesothelioma; Anaplastic; Diagnosis; Immunohistochemistry; Prognosis.

In plain English

This was a case report of one patient, written by authors in a hospital pathology department in Beijing, China. The patient, a 23-year-old man, had worsening shortness of breath for six months and denied any history of smoking or asbestos exposure. Scans showed a pleural effusion (fluid around the lung) and a well-defined tumor in the mediastinum, the space between the lungs. At surgery, the tumor filled most of the front of the mediastinum and hung from the pericardium, the sac around the heart, on a thin stalk. Under the microscope it showed abundant jelly-like (myxoid) tissue and highly abnormal cells, with more than 10 dividing cells per 10 high power fields, which made diagnosis difficult. Stains were positive for WT-1, calretinin and CK5/6, and the authors took this as confirming mesothelioma. The growth marker Ki-67 was about 50% overall and nearly 80% in the most active areas. The patient was alive one year after surgery without radiotherapy or chemotherapy. The authors concluded that clinical features help diagnosis and that immunohistochemistry is essential to confirm it.

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 23-year-old man with shortness of breath, reported by authors from the Department of Pathology, General Hospital of Beijing Military Command, Beijing, China; the date of the case is not stated
• Exposure: No asbestos exposure reported: the patient denied any history of asbestos exposure and of smoking. No fiber type is discussed for this patient.
• Main results:
  • In this patient, the tumor occupied most of the anterior mediastinum and was attached to the pericardium by a thin stalk (pedicel)
  • The removed tumor was an ovoid mass measuring 9 cm × 5 cm × 4 cm
  • The tumor cells were dividing frequently, with an estimated more than 10 mitosis figures per 10 high power fields
  • Tumor cells were strongly positive for WT-1 and moderately positive for calretinin and CK5/6; the authors considered that these results confirmed the diagnosis of mesothelioma
  • The Ki-67 labeling index in this tumor was about 50% in general and nearly 80% in the most active areas
  • The patient was still alive one year after surgery, without further radiotherapy or chemotherapy
• The authors' conclusion: The authors concluded that mesotheliomas vary greatly in appearance, that clinical features such as exact tumor position and connections to nearby organs are important aids to diagnosis, that immunohistochemistry is essential to confirm mesothelioma, and that further studies are needed on the question of survival

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pericardium, Malignant Mesothelioma, Neoplasm, Prognosis, Median Survival, Exposure History, Cytology.

Related studies

• Localized mesothelioma of the pericardium — C.M. Linthicum (1969)
• Malignant mesothelioma with a pronounced myxoid stroma: a clinical and pathological evaluation of 19 cases — J. Shia, J. Qin, et al. (2005)
• Extraskeletal myxoid chondrosarcoma of the pleura. Report of a case clinically simulating mesothelioma — S.P. Goetz, R.A. Robinson, et al. (1992)
• Myxoid variant epithelioid pleural mesothelioma defines a favourable prognosis group: an analysis of 191 patients with pleural malignant mesothelioma — F.S. Alchami, R.L. Attanoos, et al. (2017)
• Peritoneal washing cytology findings of disseminated myxoid leiomyosarcoma of uterus: report of a case with emphasis on possible differential diagnosis — W.K. Ng, P.C. Lui, et al. (2002)
• Primary myxoid sarcoma of the pleura: 5 years follow-up — R. Tosson, M. Krismann (2000)

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