Lymphangitis carcinomatosa complicating primary malignant peritoneal mesothelioma

Our plain-English summary of Lymphangitis carcinomatosa complicating primary malignant peritoneal mesothelioma, by P.S. Craft, M.S. Reading, S. Jain, et al (Thorax, 1996).

The study

• Authors: P.S. Craft, M.S. Reading, S. Jain, R.A. O'Neil
• Journal: Thorax
• Published: 1996;51(5):552-3
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A patient with malignant peritoneal mesothelioma and a diffuse pulmonary infiltrate is described. Computed tomographic scanning suggested lymphangitis carcinomatosa. This was confirmed on transbronchial biopsy to be due to metastatic mesothelioma.

In plain English

This article is a case report from Woden Valley Hospital in Canberra, Australia, describing one patient. A 52 year old man presented with two months of weight loss and upper abdominal pain. He had a history of asbestos exposure 20 years earlier; the article does not state the asbestos type. A chest X-ray at the start of symptoms was normal. An abdominal CT scan showed a diffuse mass in the omentum, and a needle biopsy found cells consistent with mesothelioma. One month later he developed a dry cough and breathlessness on exertion. Chest imaging then showed a widespread pattern that suggested lymphangitis carcinomatosa, which is tumour spread through the lung's lymph channels. Lung biopsy cells were identical to those from the abdominal biopsy, and electron microscopy showed features consistent with mesothelioma. Chemotherapy with cisplatin and doxorubicin was followed by three months of stable disease. He died eight months after presentation from respiratory failure due to progressive disease. The authors said they knew of no earlier reports of this complication. They concluded that mesothelioma should be considered in patients with lymphangitis carcinomatosa.

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 52 year old man treated at Woden Valley Hospital, Canberra, Australia, with primary malignant peritoneal mesothelioma
• Exposure: asbestos exposure 20 years before presentation; fiber type, source and amount not stated
• Main results:
  • A chest radiograph taken when symptoms began was normal.
  • An abdominal CT scan showed a diffuse omental mass. Needle biopsy showed abnormal mesothelial cells consistent with mesothelioma.
  • One month later the chest radiograph showed a widespread reticulonodular pattern with septal thickening. The abstract states that CT suggested lymphangitis carcinomatosa.
  • Transbronchial lung biopsy cells were identical to the cells from the earlier omental biopsy. Under electron microscopy they showed long branching microvilli, consistent with mesothelioma.
  • Chemotherapy with cisplatin and doxorubicin was associated with stable disease for three months.
  • The patient died eight months after presentation, from respiratory failure due to progressive disease.
• The authors' conclusion: The authors stated they were not aware of previously reported lymphangitis carcinomatosa due to malignant mesothelioma. They concluded that underlying malignant mesothelioma should be considered in patients with lymphangitis carcinomatosa, and that electron microscopy of transbronchial biopsy material may allow a rapid diagnosis.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

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

Related studies

• Diffuse pulmonary mesothelioma presenting as bilateral lymphangitis — A.P. Chahinian (1986)
• Peritoneal Deciduoid Mesothelioma: An Unusual Presentation Complicating an Already Challenging Diagnosis — N. Dominiak, W. Graybill, et al. (2017)
• Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature — S.C. Frontario, A. Loveitt, et al. (2015)
• Primary malignant peritoneal mesothelioma: appearance on F-18 FDG positron emission tomographic images — T.N. Eade, M.J. Fulham, et al. (2002)
• Lymphangitic carcinomatosis: A common radiographic manifestation of local failure following extended pleurectomy/decortication in patients with malignant pleural mesothelioma — I. Berger, K.A. Cengel, et al. (2019)
• From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation — A.D. Levy, J. Arnáiz, et al. (2008)

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