Localized pleural malignant mesothelioma

Our plain-English summary of Localized pleural malignant mesothelioma, by S. Erkiliç, I. Sari, B. Tunçözgür (Pathology International, 2001).

The study

• Authors: S. Erkiliç, I. Sari, B. Tunçözgür
• Journal: Pathology International
• Published: 2001;51(10):812-5
• Type of article: Case report
• Cited by: 18 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pleural malignant mesothelioma (PMM) is a rare tumor and it is commonly seen in the form of multiple nodules or a diffuse tumor. A localized tumor mass in the pleura is extremely rare. Only seven cases have been reported. In this report, we present an additional case of localized PMM and describe the immunohistochemical and flow cytometric findings. A 61-year-old woman, without a history of smoking or asbestos exposure, presented with a severe pain in her right shoulder and arm. Chest radiography showed a solitary mass in the right upper lung field. Computed tomography showed a 5 cm right upper lung mass. Magnetic resonance imaging showed that the mass extended to the wall of the thorax. The patient underwent surgery for total removal of the tumor. Pathology revealed a localized malignant mesothelioma. Immunohistochemical analysis showed that the tumor was strongly and diffusely positive for cytokeratins with high and low molecular weight, and focally positive for vimentin and epithelial membrane antigen (EMA), but it was negative for carcinoembryonic antigen, Factor VIII, alpha-fetoprotein and Leu-M1. Flow cytometry showed an aneuploid DNA content in the tumor. The final diagnosis was localized malignant mesothelioma (epithelial type). The patient showed signs of local recurrence 5 months after surgery, and radiotherapy was given.

In plain English

This case report from Turkey described one patient with localized pleural malignant mesothelioma, a form the authors said had been reported only seven times before. The patient, a 61-year-old woman with right shoulder and arm pain, had no history of smoking and no known asbestos exposure, either directly or through family contact. Imaging showed a 5 cm mass in the right upper lung. At surgery the tumor was invading the chest wall, and a sessile mass based on the parietal pleura was removed. Under the microscope it was made entirely of epithelioid cells. Tumor cells stained strongly for cytokeratin and were negative for CEA, Factor VIII, alpha-fetoprotein and Leu-M1. Flow cytometry showed an aneuploid (tetraploid) DNA content. The diagnosis was localized malignant mesothelioma of the epithelial type. The tumor recurred 5 months after surgery, radiation therapy was given, and the patient was alive 1 year after surgery. The authors concluded that this rare tumor resembles diffuse mesothelioma under the microscope and on staining, but may differ on flow cytometry.

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 of a single patient; the authors state that only seven cases of malignant mesothelioma appearing as a localized pleural mass had been reported before
• Who was studied: one 61-year-old woman seen at the Thoracic and Cardiovascular Surgery Clinic, Gaziantep University School of Medicine, Turkey, with pain in the right shoulder and arm
• Exposure: no history of smoking and no known exposure to asbestos, either directly or through contact with her family
• Main results:
  • Computed tomography showed a 5 cm mass in the right upper lung
  • At thoracotomy the tumor was invading the chest wall
  • A sessile mass based on the parietal pleura was removed
  • Under the microscope the tumor was composed entirely of polygonal epithelioid cells
  • Cytokeratin (high and low molecular weight) showed strong cytoplasmic staining
  • Staining for CEA, Factor VIII, alpha-fetoprotein and Leu-M1 was negative
  • Flow cytometry found an aneuploid (tetraploid) DNA content, with a DNA index of 2.0 and a high S phase percentage
  • The mass was diagnosed as localized pleural malignant mesothelioma, epithelial type
  • A recurring pleural effusion developed 5 months after the operation, and a biopsy confirmed recurrent tumor
  • Radiation therapy was given to the right upper lung field
  • The patient was alive 1 year after surgery
• The authors' conclusion: The authors concluded that localized malignant mesothelioma, a rare tumor, resembles its diffuse counterpart histologically and immunophenotypically, but may have contrasting flow cytometry findings

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Pleura, Asbestos Exposure, Thorax, Pathology, Localized Malignant Mesothelioma, Epithelial Membrane Antigen (EMA), Carcinoembryonic Antigen (CEA).

Related studies

• Flow cytometric analysis of a localized malignant mesothelioma — J.J. Gómez-Román, R. Mons-Lera, et al. (2002)
• Localized fibrous tumor of the serosal cavities. Immunohistochemical, electron-microscopic, and flow-cytometric DNA study — A.K. el-Naggar, J.Y. Ro, et al. (1989)
• Localized malignant mesothelioma of the epithelial type occurring as a primary hepatic neoplasm: a case report with review of the literature — J. Imura, K. Ichikawa, et al. (2002)
• Localized fibrous tumours of the pleura: 15 new cases and review of the literature — M. Suter, S. Gebhard, et al. (1998)
• Cystic renal cell carcinoma: arose as a simple cyst, recurred repeatedly as a multicystic mass and finally presented as a solid mass — Y. Shishikura, M. Furusato, et al. (1998)
• Localized fibrous tumors (LFTs) of the pleura: clinical data, asbestos burden, and syntactic structure analysis applied to newly defined angiogenic/growth-regulatory effectors — K. Kayser, J. Trott, et al. (2005)

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