Malignant pleural mesothelioma with heterologous osteoblastic elements: computed tomography, magnetic resonance, and positron emission tomography imaging characteristics of a rare tumor

Our plain-English summary of Malignant pleural mesothelioma with heterologous osteoblastic elements: computed tomography, magnetic resonance, and positron emission tomography imaging characteristics of a rare tumor, by R.A. Salgado, R. Corthouts, P.M. Parizel, et al (Journal of Computer Assisted Tomography, 2005).

The study

• Authors: R.A. Salgado, R. Corthouts, P.M. Parizel, P. Germonpré, L. Carp, P. Van Schil, E. Van Marck
• Journal: Journal of Computer Assisted Tomography
• Published: 2005;29(5):653-6
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The imaging findings of a rare mixed type of malignant mesothelioma of the pleura with heterologous bone stroma in a patient without a previous history of asbestos exposure are reported. Imaging findings of this type of bone-forming pleural mesothelioma are scarcely reported in the literature, with only a few case reports describing findings on conventional radiography, computed tomography, and magnetic resonance imaging. To the best of our knowledge, no positron emission tomography imaging characteristics of this type of mesothelioma have been previously reported.

In plain English

This case report described one 64-year-old woman with a rare mixed type of malignant pleural mesothelioma containing bone-forming (heterologous osteoblastic) tissue. The article states she had no history of asbestos exposure. She first had shortness of breath and right-sided chest pain. A first open biopsy showed only mesothelial hyperplasia with mature osseous metaplasia and no signs of malignancy. Six months later, a CT scan showed extensive, uniform thickening and densification of the right pleura covering the right lung, with a loculated pleural effusion. On MR imaging the dense areas did not create a signal void, suggesting they were not typical calcified pleural plaques. The mass enhanced intensely after gadolinium, and MR showed signs of invasion of the pericardium and lung base not clearly seen on CT. A PET scan showed moderately increased uptake in the right pleura. A second biopsy confirmed the mesothelioma. She died 18 months after diagnosis, with liver and lung metastases. The authors concluded that pleural densifications are a feature of this tumor and should be regarded with suspicion.

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 (imaging findings of a single patient)
• Who was studied: one 64-year-old woman, evaluated at the University Hospital of Antwerp, Belgium
• Exposure: the article reports no history of asbestos exposure; no fiber type or other exposure is described
• Main results:
  • A first open biopsy showed only mesothelial hyperplasia with mature osseous metaplasia, with no signs of malignancy
  • Six months later, CT showed extensive uniform thickening and densification of the right pleura completely covering the right lung, with a complex loculated pleural effusion at the lung base
  • On MR imaging the dense areas seen on CT did not create a signal void, suggesting they were not typically calcified pleural plaques
  • The pleural mass showed diffuse and intense enhancement after intravenous gadolinium
  • MR showed signs of invasion of the pericardium and lung base that were not clearly seen on CT; the authors state MR was superior to CT in evaluating infiltration in this case
  • 18F-fluorodeoxyglucose PET showed diffuse, moderately increased tracer uptake in the right pleura
  • A second open biopsy showed malignant pleural mesothelioma of the mixed epithelial-mesenchymal type with heterologous osteoblastic stroma elements
  • The patient died 18 months after diagnosis, with liver and lung metastases
• The authors' conclusion: The authors concluded that pleural densifications are a feature of this rare malignant tumor, reflecting osteoid mineralization, and should be regarded with suspicion

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Malignant Mesothelioma, Pleura, Asbestos Exposure, Mesothelioma.

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