Malignant fibrous histiocytoma of the lung in a patient with a history of asbestos exposure

Our plain-English summary of Malignant fibrous histiocytoma of the lung in a patient with a history of asbestos exposure, by A.C. Reifsnyder, H.J. Smith, T.J. Mullhollan, et al (AJR. American Journal of Roentgenology, 1990).

The study

• Authors: A.C. Reifsnyder, H.J. Smith, T.J. Mullhollan, E.L. Lee
• Journal: AJR. American Journal of Roentgenology
• Published: 1990;154(1):65-6
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002588).

Summary of the article

The authors reported a case of primary malignant fibrous histiocytoma of the lung, a rare tumour, in a patient with a history of asbestos exposure, and reviewed the clinical and radiographic findings in the literature. A 49-year-old man presented with fatigue and hemoptysis. He had smoked 3-4 packs of cigarettes per day for 35 years and had been exposed to asbestos during military service 30 years earlier. Chest radiographs and CT showed a large noncalcified mass in the right lung base and pleural plaques, some calcified. Fine-needle aspiration suggested squamous cell carcinoma, and a technetium-99m methylene diphosphonate bone scan showed increased soft-tissue uptake at the right lung base. After right middle and lower lobectomy, microscopic and ultrastructural studies showed a poorly differentiated mesenchymal tumour consistent with malignant fibrous histiocytoma; epithelial tumours and malignant mesothelioma were excluded. Biopsy of the pleural plaques showed hyalinized fibrous scar. The patient was clinically free of disease 10 months later. To the authors' knowledge, this was the first documented case in a patient with asbestos exposure; they noted that no causal association between smoking or asbestos exposure and this tumour had been described. They concluded that, when primary pulmonary malignant fibrous histiocytoma is suspected, a careful search for tumour elsewhere must be made to exclude a metastasis.

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.

In plain English

This case report describes a 49-year-old man with primary malignant fibrous histiocytoma, a type of sarcoma, in the lung. He had smoked 3-4 packs of cigarettes a day for 35 years and was exposed to asbestos during military service 30 years earlier. The article does not name the asbestos type. He came in with fatigue and coughing up blood. Chest X-rays and CT scans showed a large mass at the base of the right lung and pleural plaques, some calcified, throughout the chest. A needle biopsy first suggested squamous cell carcinoma. Surgeons removed the right middle and lower lobes. The tumor was a poorly differentiated mesenchymal tumor consistent with malignant fibrous histiocytoma. Malignant mesothelioma and epithelial tumors were considered and excluded. Biopsy of the pleural plaques showed scar tissue, and the lymph nodes had no tumor. He was clinically free of disease 10 months later. The authors stated their patient was the only reported case with a history and X-ray signs of asbestos exposure. They also noted that no causal link between smoking or asbestos and this tumor had been described.

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, with a discussion of previously published cases
• Who was studied: one 49-year-old man with fatigue and hemoptysis (coughing up blood); the article does not state where or when he was treated
• Exposure: asbestos exposure during military service 30 years before (fiber type not stated), plus smoking of 3-4 packs of cigarettes per day for 35 years
• Main results:
  • Chest radiographs showed a noncalcified mass in the right lower lobe and pleural plaques on both sides
  • CT showed pleural plaques, some calcified, throughout the chest
  • Fine-needle aspiration of the mass initially indicated squamous cell carcinoma
  • A bone scan showed increased uptake in the soft tissue at the right lung base
  • Biopsy of the pleural plaques showed hyalinized fibrous scar
  • After right middle and lower lobectomy, the tumor was found to be a poorly differentiated mesenchymal tumor consistent with malignant fibrous histiocytoma
  • Because of the asbestos history and plaques, epithelial tumors and malignant mesothelioma were considered and excluded
  • The patient was clinically free of disease 10 months after surgery
• The authors' conclusion: The authors stated this was the only reported case of this lung tumor with a history and radiographic signs of asbestos exposure. They noted that no causal association between smoking or asbestos exposure and malignant fibrous histiocytoma had been described.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Hemoptysis, Chest X-Ray, Pleural Plaques, Fine-Needle Aspiration, Squamous Cell Carcinoma, Mesothelioma, Biopsy.

Related studies

• Coexistence of a malignant fibrous histiocytoma and asbestos exposure. Brief report — T. Kishimoto (1992)
• So-called sclerosing hemangioma of the lung. Evidence for mesothelial origin — A.L. Katzenstein, D.L. Weise, et al. (1983)
• Pulmonary crystal-storing histiocytoma in a patient without a lymphoproliferative disorder — W.S. Lee, S.R. Kim, et al. (2009)
• Multimodality therapy for malignant mesothelioma based on a study of natural history — K.H. Antman, R.H. Blum, et al. (1980)
• Malignant pleural mesothelioma: history, controversy and future of a manmade epidemic — O.D. Røe, G.M. Stella (2015)
• Natural history and epidemiology of malignant mesothelioma — K.H. Antman (1993)

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