Pericardial Mesothelioma in a 35-Year-Old Male With Ulcerative Colitis

Our plain-English summary of Pericardial Mesothelioma in a 35-Year-Old Male With Ulcerative Colitis, by J. Iliff, N.K. Bart, S. Ghaly, et al (Circulation. Cardiovascular Imaging, 2019).

The study

• Authors: J. Iliff, N.K. Bart, S. Ghaly, E. Granger, C.J. Holloway
• Journal: Circulation. Cardiovascular Imaging
• Published: 2019;12(1):e008659
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This article is a case report from St Vincent's Hospital in Sydney, Australia, describing one patient: a 35-year-old man with ulcerative colitis. The article states he was a nonsmoker and had no history of occupational exposure to asbestos. He first came in with chest pain consistent with pericarditis, which is inflammation of the sac around the heart. Anti-inflammatory treatment did not resolve the problem. Heart ultrasound and cardiac MRI showed fluid around the heart and a thickened pericardium. A PET-CT scan showed diffuse nodules with increased tracer uptake in the pericardium and in the outer layer of the heart's left ventricle. Heart catheterisation confirmed constrictive physiology, meaning the thickened pericardium was restricting how the heart filled. Surgery to remove the pericardium led to a tissue diagnosis of primary pericardial mesothelioma. The patient died about 12 months after he first presented. The authors concluded that mesothelioma should be considered when pericardial effusions keep returning or pericarditis does not respond to treatment. They wrote that cardiac MRI and PET-CT are useful tests to help reach the diagnosis earlier.

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 35-year-old male with a history of ulcerative colitis, treated at St Vincent's Hospital, Sydney, Australia
• Exposure: The article reports no history of occupational exposure to asbestos; the patient was a nonsmoker. No fiber type or dose is reported.
• Main results:
  • Echocardiogram and cardiac magnetic resonance imaging showed a circumferential pericardial effusion and a thickened pericardium; cardiac MRI findings were consistent with effusive constrictive pericardial pathology
  • PET-CT showed diffuse nodularity with increased fluorodeoxyglucose uptake in the pericardium, as well as in the epicardium of the left ventricular wall
  • Left and right heart catheterisation confirmed constrictive physiology
  • Pericardiectomy revealed a thickened nodular pericardium, and histology gave a diagnosis of primary pericardial mesothelioma, with positive immunochemistry markers (CK7, CK5/6, D2 40, Calretinin and WT1)
  • The patient deteriorated and died approximately 12 months after initial presentation
• The authors' conclusion: The authors concluded that mesothelioma should be considered in recurrent and refractory pericardial effusions and resistant pericarditis, and that cardiac magnetic resonance and PET-CT are useful tests to aid earlier diagnosis

Topics

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

Medical terms in this study, explained in our Lexicon: Pericardial Mesothelioma.

Related studies

• Recurrence of Pericardial Mesothelioma Affecting the Myocardium After Pericardial Resection — M. Rodríguez, H.R. Mallidi, et al. (2018)
• A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report — C. Mensi, A. Romano, et al. (2017)
• An autopsy case of a malignant pericardial mesothelioma in a Japanese young man — M. Watanabe, H. Suzuki, et al. (1999)
• Pericardial mesothelioma masquerading as a benign pericardial effusion — N.L. Coplan, A.J. Kennish, et al. (1984)
• Recurrent pericardial effusion with pericardial amyloid deposition: a case report and literature review — H. Itagaki, T. Yamamoto, et al. (2020)
• Three-year survival after surgery for primary malignant pericardial mesothelioma: report of a case — K. Fujita, M. Hata, et al. (2014)

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