Nodular hemangiomatosis of pleura and peritoneum

Our plain-English summary of Nodular hemangiomatosis of pleura and peritoneum, by S. Ribback, A. Thiele, C. Rosenberg, et al (Pathology, Research and Practice, 2011).

The study

• Authors: S. Ribback, A. Thiele, C. Rosenberg, S. Friesecke, V. Neumann, A. Tannapfel, F. Dombrowski
• Journal: Pathology, Research and Practice
• Published: 2011;207(11):718-21
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Multiple, simultaneously occurring hemangiomas in one or more organs are known as hemangiomatosis syndromes in the context of phacomatosis manifesting in childhood. Nevertheless, hemangiomas of the serous membranes are extremely rare and often present as solitary lesions. We report the case of an elderly patient who suffered from diffuse hemangiomatosis of the visceral peritoneum and pleura and deceased due to acute respiratory distress syndrome following persistent and unmanageable pulmonary hemorrhage. We present an unusual case of a disseminated but histologically benign appearing hemangiomatosis of the serous membranes.

Copyright © 2011 Elsevier GmbH. All rights reserved.

In plain English

This was a case report from Greifswald, Germany, about a 78-year-old man admitted to hospital with recurrent coughing up of blood and lower gastrointestinal bleeding. Lung bleeding persisted despite treatment, and he died from respiratory and circulatory failure. At autopsy, multiple hemangiomas (blood-vessel tumors) of the peritoneum and retroperitoneum, attached to the visceral pleura and peritoneum, measured up to 10 cm; on CT, the largest tumor, next to the liver, measured 12.7 cm. Microscopically the tumors showed no signs of malignancy, with a Ki-67 proliferation index of 1–2%. Autopsy also found widespread plaques up to 4 mm thick on the parietal pleura of both sides. Lung dust analysis found 50 asbestos bodies and 20 asbestos fibers per gram of wet lung tissue (stated limit value 22). The fiber type was not reported. There was no asbestos-associated lung fibrosis, and the man had no occupational asbestos exposure, having worked in an administrative position. The authors said the findings indicated asbestos exposure. Because no similar cases had been reported, they could only speculate that asbestos in the lung might have contributed to the hemangiomas.

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, with autopsy)
• Who was studied: one 78-year-old man treated at Ernst-Moritz-Arndt University of Greifswald, Germany, who died in hospital and was autopsied
• Exposure: Asbestos burden in the lung, found at autopsy by light-microscopy lung dust analysis; fiber type not specified. The patient had no occupational asbestos exposure and had worked in an administrative position.
• Main results:
  • At autopsy, the lesions were multiple hemangiomas of the peritoneum and retroperitoneum measuring up to 10 cm in diameter.
  • On abdominal CT, the biggest tumor measured 12.7 cm in longest diameter and was adjacent to the liver.
  • The tumors showed low proliferation (Ki-67 labeling index 1–2%) and no indication of a malignant process.
  • Widespread bilateral plaques up to 4 mm thick were found on the costal and diaphragmatic parietal pleura.
  • Lung dust analysis showed 50 asbestos bodies and 20 asbestos fibers per gram of wet lung tissue (collective limit value 22).
  • No asbestos-associated lung fibrosis was seen in the lung tissue.
  • The patient died from refractory respiratory and circulatory failure after 1 week in intensive care.
• The authors' conclusion: The authors concluded that the pleural plaques and positive lung dust analysis indicated asbestos exposure. Since no other cases had been reported, they could only speculate that asbestos stored in the lung might have influenced the development of the multiple hemangiomas.
• Limitations the authors state:
  • No other cases have been reported, so the suggested link with asbestos is speculative.
  • The cause of the pulmonary hemorrhage remained unclear, because the hemangiomas showed no direct infiltrating growth.

Topics

Medical terms in this study, explained in our Lexicon: Pleura, Peritoneum.

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