Miliary mesothelioma

Our plain-English summary of Miliary mesothelioma, by M. Huncharek (Chest, 1994).

The study

• Author: M. Huncharek
• Journal: Chest
• Published: 1994;106(2):605-6
• Type of article: Case report
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Metastases in pleural mesothelioma usually occur late in the disease process. Diffuse involvement of the lung parenchyma is rare. A patient with miliary pulmonary parenchymal involvement with malignant mesothelioma is described. To our knowledge, this represents the first such case reported.

In plain English

This article was a case report about one patient, a 61-year-old white woman. She had 3 months of worsening left lower chest pain, shortness of breath on exertion, and fatigue. Her first chest x-ray showed fluid around the left lung (a pleural effusion), with clear lung fields. She had a 40-pack-year smoking history and denied any toxic exposures or exposure to asbestos. Repeated drainage of the fluid and two pleural biopsies found no tumor and no signs of tuberculosis. Later x-ray and CT scans showed many small nodules spread through both lungs (a "miliary" pattern). Doctors first believed this was miliary tuberculosis and gave her tuberculosis drugs, but she showed little improvement. An open lung biopsy with pleural biopsy found thickened, scarred pleura. Under the microscope the tissue showed malignant mesothelioma, consistent with pleural mesothelioma. The author stated that, to their knowledge, this was the first reported case with a miliary pattern on imaging. The author concluded that this pattern should be recognized as a possible presentation of pleural mesothelioma. The article did not report what happened to the patient afterward.

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 (one patient)
• Who was studied: One 61-year-old white woman with chest pain, shortness of breath and a left-sided pleural effusion; the author was at the Department of Radiation Oncology, Massachusetts General Hospital, Boston; dates of care not stated
• Exposure: No asbestos exposure was reported: the patient denied any toxic exposures or exposure to asbestos. She had a 40-pack-year smoking history.
• Main results:
  • In this patient, repeated thoracentesis (four times) and two pleural biopsies were all negative for granulomata, acid-fast organisms, or tumor
  • In this patient, a chest x-ray and CT scan taken 1 week after admission showed a miliary pattern, which was believed to represent miliary tuberculosis
  • The patient was treated with tuberculosis drugs (isoniazid, rifampin, and ethambutol; streptomycin and pyrazinamide were added later) and showed little improvement in symptoms or chest x-ray findings
  • In this patient, open lung biopsy with pleural biopsy showed malignant mesothelioma; staining was negative for carcinoembryonic antigen and positive for keratin, consistent with pleural mesothelioma
• The authors' conclusion: The authors concluded that, to their knowledge, this was the first reported case of pleural mesothelioma with a radiographic miliary pattern, and that diffuse lung metastases in a miliary pattern should be recognized as a possible presentation of pleural mesothelioma.

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, Pleural Mesothelioma, Parenchyma, Malignant Mesothelioma.

Related studies

• Diffuse intrapulmonary malignant mesothelioma presenting with miliary pulmonary nodules: A case report — T. Hida, M. Hamasaki, et al. (2015)
• Miliary spread of malignant pleural mesothelioma without a clinically identifiable pleural tumour — A.W. Musk, J. Dewar, et al. (1991)
• Epithelioid pleural mesothelioma concurrently associated with miliary pulmonary metastases and minimal change nephrotic syndrome - A hitherto undescribed case — Y. Tsukamoto, T. Otsuki, et al. (2015)
• Miliary mesothelioma: a new clinical and radiological presentation in mesothelioma patients with prolonged survival after trimodality therapy — L. Purek, S. Laroumagne, et al. (2011)
• Miliary Mesothelioma — D. Jayabalan, M. Donaghy, et al. (2025)
• Asbestos-induced lung injury in the sheep model: the initial alveolitis — R. Bégin, M. Rola-Pleszczynski, et al. (1983)

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