Malignant mesothelioma presenting as a solitary perifissural nodule

Our plain-English summary of Malignant mesothelioma presenting as a solitary perifissural nodule, by L. Mo, B. Adler, C. Green, et al (Internal Medicine Journal, 2020).

The study

• Authors: L. Mo, B. Adler, C. Green, F.J.H. Brims
• Journal: Internal Medicine Journal
• Published: 2020;50(12):1592-1594
• Type of article: Letter
• Read it: PubMed · Publisher

In plain English

This letter to the editor was a case report about one man. A 71-year-old man in the Western Australian Asbestos Review Programme had an 11-mm nodule beside the left oblique fissure (a boundary between lobes of the lung) on his yearly low-dose CT screening scan. Looking back, the scan from one year earlier showed a 2-mm nodule in the same place. He had no symptoms and normal lung function. He reported significant exposure to crocidolite (blue asbestos) from living in the former asbestos mining town of Wittenoom, and 10 pack-years of smoking between ages 15 and 30. A PET scan showed mild uptake in the nodule and nothing of concern elsewhere. A needle sample showed atypical cells that stained with mesothelial markers and showed loss of nuclear BAP-1 expression. The authors wrote that, to their knowledge, this was the first case of mesothelioma diagnosed in an isolated perifissural nodule, a finding conventionally considered benign. They concluded that the case highlights the need for caution when assessing such nodules in people with significant asbestos exposure. The letter did not report treatment or outcome.

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 (letter to the editor) describing one patient
• Who was studied: One 71-year-old man taking part in an asbestos screening programme in Western Australia
• Exposure: Significant crocidolite (blue asbestos) exposure from living in the former asbestos mining town of Wittenoom, Western Australia; also 10 pack-years of tobacco smoking from age 15 to 30
• Main results:
  • The annual low-dose CT screening scan showed an 11-mm nodule along the left oblique fissure
  • On review, the screening CT from 1 year earlier showed a 2-mm nodule in the same location
  • The patient had no symptoms and normal lung function
  • The PET scan showed mild uptake in the nodule (SUV max 2.3) and no other lesions of concern elsewhere in the body
  • Cells from a CT-guided fine-needle aspirate stained with the mesothelial markers calretinin, D2-40 and CK5/6, and showed loss of nuclear BAP-1 expression
  • The cells did not react with the markers TTF1, P40, MOC31 or CEA
• The authors' conclusion: The authors concluded that the case highlights the need for caution when assessing solitary perifissural nodules in people with significant asbestos exposure

Topics

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

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

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• Solitary pulmonary nodule in a patient without asbestos exposure — J.F. Turner, C. Gronbeck, et al. (1992)
• Diffuse epithelial pleural mesothelioma presenting as a solitary lung mass — M.H. Gotfried, S.F. Quan, et al. (1983)
• External validation and recalibration of the Brock model to predict probability of cancer in pulmonary nodules using NLST data — A. Winter, D.R. Aberle, et al. (2019)
• Isolated pulmonary amyloidoma: A rare cause of solitary pulmonary nodule — D. DeCicco, E. Alshaikhnassir, et al. (2023)
• Peritoneal mesothelioma presenting as a skin nodule — C. Abban, M. Viglione (2009)

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