Pleural fluid acidosis in the malignant variant of benign pleural mesothelioma

Our plain-English summary of Pleural fluid acidosis in the malignant variant of benign pleural mesothelioma, by R.D. Brandstetter, F.M. Tamarin, O.J. O'Neill, et al (Chest, 1990).

The study

• Authors: R.D. Brandstetter, F.M. Tamarin, O.J. O'Neill, A.F. Andresen, W.G. Schraft, J. Perez
• Journal: Chest
• Published: 1990;98(2):514-5
• Type of article: Case report, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor described a single case. The patient was an 85-year-old man who had worked as a sculptor, which the authors described as work without asbestos exposure. He had a 40 pack-year smoking history. A chest x-ray showed a right pleural effusion with pleural and pericardial calcifications. Fluid was drawn from the chest on two days in a row, the first time removing 800 ml of blood-tinged fluid. The fluid pH was 7.02 and 7.16, while blood pH at those times was 7.49 and 7.46. He needed mechanical ventilation and died of cardiopulmonary arrest on the fifth hospital day. At autopsy, the right pleura had been replaced by firm tissue up to 15 mm thick, which extended into the pericardial sac and the superficial heart muscle. Under the microscope this was a proliferation of benign fibrous tissue with no mitotic activity. The authors classed the case as the malignant variant of benign pleural mesothelioma. They proposed that a pleural fluid pH below 7.30 supports that variant and implies a poor outcome, but said more reports are needed to substantiate this.

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 (letter to the editor)
• Who was studied: one 85-year-old man with a 40 pack-year smoking history and congestive heart failure, treated at New Rochelle Hospital Medical Center, New York
• Exposure: The authors reported that he worked as a sculptor without asbestos exposure. No fiber exposure was described.
• Main results:
  • Chest x-ray showed a right pleural effusion with pleural and pericardial calcifications.
  • 800 ml of serosanguinous (blood-tinged) fluid was removed at the first thoracentesis.
  • Pleural fluid LDH was 756 and 701 IU/ml on the two days.
  • Pleural fluid pH was 7.02 and 7.16 on the two days, with corresponding blood pH of 7.49 and 7.46.
  • The patient needed mechanical ventilation and died of cardiopulmonary arrest on the fifth hospital day.
  • At autopsy, the right visceral and parietal pleura had been replaced by tissue up to 15 mm thick.
  • Histology showed a proliferation of benign fibrous tissue with no mitotic activity. Within the pericardial sac it extended into the superficial myocardium.
• The authors' conclusion: The authors contended that a low pleural fluid pH (below 7.30) supports the presence of the malignant variant of benign pleural mesothelioma and implies a poor outcome, but said more reports are necessary to substantiate this.
• Limitations the authors state:
  • The proposal rests on one case; the authors said more reports of the fluid's characteristics are necessary.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Pleural plaques and thickening.

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

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