Peritoneal mesothelioma

Our plain-English summary of Peritoneal mesothelioma, by M.P. Banner, V.K. Gohel (Radiology, 1978).

The study

• Authors: M.P. Banner, V.K. Gohel
• Journal: Radiology
• Published: 1978;129(3):637-40
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002111).

Abstract

Five cases of malignant peritoneal mesothelioma are reported. Its radiographic manifestations consisted of a desmoplastic mesenteric process with or without a localized mass displacing gastrointestinal structures. Appreciation of the nature of this tumor permits pathologic-radiologic correlation and an understanding of the radiographic changes. Though numerous conditions may produce similar findings, combining a history of asbestos exposure or chest radiograph findings of asbestosis with gastrointestinal findings of desomplasia should narrow the diagnostic possibilities.

In plain English

This article, by radiologists in Philadelphia, reported five patients with malignant peritoneal mesothelioma, a cancer of the abdominal lining. Each diagnosis was confirmed by examining tissue, and the authors saw all five over five years. The patients were three women and two men aged 22 to 82. Only two had a history of asbestos exposure: the case table lists 29 years for one and 50 years for the other, and names no fiber type. On X-ray studies, most cases showed bowel loops fixed in place, with surface changes next to tumor deposits. Some patients had widened and narrowed stretches of small bowel, with or without partial blockage, and two had a distinct mass pushing bowel loops aside. The authors called the overall pattern desmoplastic, meaning a scarring process in the tissue holding the bowel. They called the X-ray findings striking but nonspecific. They concluded that combining a history of asbestos exposure, or chest X-ray signs of asbestosis, with gastrointestinal signs of desmoplasia should narrow the possible diagnoses. They also noted that only a minority of such patients show chest X-ray signs of asbestosis.

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 series (5 case reports) with discussion of radiologic diagnosis
• Who was studied: Five patients with histologically proved malignant peritoneal mesothelioma, seen by the authors over five years at Philadelphia hospitals (University of Pennsylvania; Thomas Jefferson University Hospital; Graduate Hospital). Per Table I, they were a 51-year-old woman, a 22-year-old man, a 69-year-old woman, an 82-year-old man and a 36-year-old woman.
• Exposure: Asbestos exposure was reported in 2 of the 5 patients. Table I lists 29 years of exposure for the 51-year-old woman and 50 years for the 82-year-old man, and none for the other three. No fiber type, product or job is given.
• Main results:
  • Most of the 5 cases showed fixation and serosal (outer-surface) changes of bowel loops next to tumor implants.
  • Areas of widening and narrowing of the small bowel, with or without partial obstruction, were seen.
  • Discrete masses displacing bowel loops were present in 2 of the 5 patients.
  • In 1 case, small-bowel loops were fixed in a star-shaped (stellate) configuration in the mid-abdomen.
  • Across the cases, the overall radiographic pattern was a desmoplastic (scarring) process in the mesentery, with pulling (traction) changes on the bowel loops.
  • For the 51-year-old woman with 29 years of asbestos exposure, Table I records pulmonary asbestosis at autopsy.
• The authors' conclusion: The authors concluded that the radiographic findings are striking but nonspecific. Although numerous conditions can produce similar findings, they wrote that combining a history of asbestos exposure, or chest X-ray findings of asbestosis, with gastrointestinal findings of desmoplasia should narrow the diagnostic possibilities.
• Limitations the authors state:
  • The radiographic findings are nonspecific, which makes diagnosis before surgery difficult.
  • Only a minority of patients with peritoneal mesothelioma show chest X-ray changes of pulmonary asbestosis, which limits the usefulness of this clue.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Desmoplastic Mesothelioma, Asbestos Exposure, Chest X-Ray.

Related studies

• Simultaneous bilateral spontaneous pneumothorax in a patient with peritoneal and pleural papillary mesothelioma — P. Höllinger, D. Gaeng (1997)
• Peritoneal mesothelioma — J.R. Young, E.R. Reddy (1980)
• Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature — S.C. Frontario, A. Loveitt, et al. (2015)
• Primary malignant peritoneal mesothelioma: appearance on F-18 FDG positron emission tomographic images — T.N. Eade, M.J. Fulham, et al. (2002)
• Lymphangitis carcinomatosa complicating primary malignant peritoneal mesothelioma — P.S. Craft, M.S. Reading, et al. (1996)
• Splenic localization of the peritoneal mesothelioma: case report and literature revue — D. D'Abbicco, A. Conversano, et al. (2012)

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