Mesothelioma after lung transplantation

Our plain-English summary of Mesothelioma after lung transplantation, by P.N. Chhajed, L. Bubendorf, H. Hirsch, et al (Thorax, 2006).

The study

• Authors: P.N. Chhajed, L. Bubendorf, H. Hirsch, A. Boehler, W. Weder, M. Tamm
• Journal: Thorax
• Published: 2006;61(10):916-7
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The case history is presented of a lung transplant recipient who developed malignant mesothelioma. This is thought to be the first such report. Mesothelioma should be suspected in lung transplant recipients with a haemorrhagic pleural effusion in the native lung when there is no convincing evidence for bronchogenic carcinoma or post transplant lymphoproliferative disease, even in the absence of exposure to asbestos.

In plain English

This was a case report of one patient: a 63-year-old woman who had a right single lung transplant for idiopathic pulmonary fibrosis in June 1998. In July 2003 she developed a bloody (haemorrhagic) pleural effusion, a collection of fluid, around her left lung, which was her own non-transplanted lung. Fluid tests showed cells suspicious for adenocarcinoma. Pleural biopsies then led to a diagnosis of malignant mesothelioma of mixed epithelioid and sarcomatoid subtype. Only palliative care was given, and she died. Autopsy confirmed biphasic malignant mesothelioma spreading through the pleura, pericardium and diaphragm. No asbestos bodies were seen in the lung tissue. The authors reported no history of asbestos exposure. She tested negative for SV40, JC virus and BK virus, so the origin of the mesothelioma could not be determined. The authors believed this was the first such report. They concluded that mesothelioma should be suspected in lung transplant recipients with a haemorrhagic pleural effusion in the native lung when there is no convincing evidence for bronchogenic carcinoma or post transplant lymphoproliferative disease, even without 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
• Who was studied: One patient: a 63-year-old woman who had a right single lung transplant for idiopathic pulmonary fibrosis in June 1998. The authors were from University Hospital Basel and University Hospital Zurich, Switzerland.
• Exposure: No history of asbestos exposure was reported, and no asbestos bodies were seen in her lung tissue at autopsy. After the transplant she received immunosuppressive drugs (cyclosporine, mycophenolate mofetil and prednisolone).
• Main results:
  • In July 2003 the patient had a squamous cell carcinoma of the scalp surgically removed. In the same month she developed a haemorrhagic pleural effusion on the left side, the side of her native (non-transplanted) lung.
  • Cytology of the pleural fluid showed cells suspicious for adenocarcinoma. However, staining for the epithelial marker Ber-EP4 was negative.
  • Histological and immunohistochemical examination of pleural biopsies led to a diagnosis of malignant mesothelioma of mixed epithelioid and sarcomatoid subtype.
  • Radical surgery and chemotherapy were not used, and pleurodesis was not possible. Only palliative care was given, and the patient died.
  • Autopsy confirmed a biphasic malignant mesothelioma with extensive infiltration of the pleura, pericardium and diaphragm. No asbestos bodies were seen in the lung tissue.
  • The patient tested negative by PCR for SV40, JC virus and BK virus. The origin of the mesothelioma could not be determined.
• The authors' conclusion: The authors stated that, to their knowledge, this was the first report of malignant mesothelioma in a lung transplant recipient. They concluded that mesothelioma should be suspected in lung transplant recipients with a haemorrhagic pleural effusion in the native lung when there is no convincing evidence for bronchogenic carcinoma or post transplant lymphoproliferative disease, even in the absence of exposure to asbestos.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Transplant, Malignant Mesothelioma, Pleural Effusion, Bronchogenic Carcinoma.

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