Malignant pleural mesothelioma with osteoblastic heterologous elements: CT and MR imaging findings

Our plain-English summary of Malignant pleural mesothelioma with osteoblastic heterologous elements: CT and MR imaging findings, by G. Chave, L. Chalabreysse, G. Picaud, et al (AJR. American Journal of Roentgenology, 2002).

The study

• Authors: G. Chave, L. Chalabreysse, G. Picaud, N. Blineau, R. Loire, F. Thivolet, Y. Berthezène, C.P. Douek, B. Marchand
• Journal: AJR. American Journal of Roentgenology
• Published: 2002;178(4):949-51
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This case report described the CT and MR imaging findings in a rare histologic subtype of malignant pleural mesothelioma with osteoblastic heterologous elements. The authors noted that only 13 such cases had previously been reported and that MR findings had not been described before. A 59-year-old man with a history of smoking and asbestos exposure presented with right chest pain. A chest radiograph showed a right pleural effusion with focal pleural thickening, and the initial CT scan showed right focal pleural thickening. A thoracoscopic pleural biopsy showed epithelial cells and malignant spindle cells, and malignant pleural mesothelioma was diagnosed. He received intrapleural gamma interferon. Three years later he was admitted with Pancoast-Tobias syndrome. Unenhanced CT showed that the pleural thickening had grown and that pleural calcifications had appeared. MR imaging confirmed chest wall and apical extension of the tumor. Calcified areas gave no signal on T1- and T2-weighted images, and noncalcified tumor gave a bright T2 signal. MR imaging also excluded a suspected superior vena cava syndrome. A repeat biopsy showed foci of malignant osteoid tissue, and the diagnosis was revised to mesothelioma with osteoblastic heterologous elements. The patient received palliative treatment and died 3 years after the initial diagnosis. The authors concluded that, although pleural calcification usually suggests benign disease, it may rarely occur in this tumor.

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 was a case report of one patient: a 59-year-old man with a history of smoking and asbestos exposure who had right chest pain. Imaging showed a right pleural effusion and focal thickening of the pleura (the lining around the lung). A biopsy showed epithelial cells and malignant spindle cells, and malignant pleural mesothelioma was diagnosed. The patient was treated with gamma interferon given inside the chest. Three years later, CT showed that the thickening had grown and spread into the chest wall, with new calcifications. MR imaging showed tumor extending into the chest wall and lung apex, with calcified areas giving no signal. It also ruled out a suspected superior vena cava syndrome. A second biopsy found malignant osteoid (bone-forming) tissue. The diagnosis became malignant pleural mesothelioma with osteoblastic heterologous elements, a rare subtype. The patient received palliative treatment and died 3 years after the first diagnosis. The authors noted that pleural calcification, usually considered highly suggestive of benign disease, may rarely occur in this tumor. The article did not describe the type or amount of asbestos exposure.

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 (single patient)
• Who was studied: one 59-year-old man with a history of smoking and asbestos exposure; the place and dates of care are not stated
• Exposure: a history of asbestos exposure (and smoking); no fiber type, job, product or dose is given
• Main results:
  • The first pleural biopsy showed epithelial cells and a sarcomatous component of malignant spindle cells; malignant pleural mesothelioma was diagnosed.
  • Three years later, unenhanced CT showed that the pleural thickening had increased and spread into the chest wall, with two coarse calcifications.
  • MR imaging showed chest wall and apical extension of the tumor.
  • On MR imaging the tumor had areas of bright signal on T2-weighted images, and its calcified areas had no signal on T1- and T2-weighted images.
  • MR imaging excluded a clinically suspected superior vena cava syndrome.
  • A second pleural biopsy, taken 3 years after the first, showed malignant tumor cells with osteoid tissue, leading to a diagnosis of malignant pleural mesothelioma with osteoblastic heterologous elements.
  • The patient received palliative treatment and died 3 years after the initial diagnosis.
• The authors' conclusion: The authors concluded that, although pleural calcification is usually considered highly suggestive of benign disease, it may rarely occur in malignant pleural mesothelioma with osteoblastic heterologous elements.
• Limitations the authors state:
  • The authors stated that one calcification near the right paratracheal space may have been direct tumor extension, but that an enlarged calcified lymph node could not be formally excluded.

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, Heterologous Elements, Histological Subtype, Asbestos Exposure, Chest X-Ray, Pleural Effusion, Pleural Thickening, CT Scan.

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