Pleural mesothelioma in patient with pulmonary tuberculosis: report of a case

Our plain-English summary of Pleural mesothelioma in patient with pulmonary tuberculosis: report of a case, by U.J. Martinis, V.R. Radovic (Diseases of the Chest, 1965).

The study

• Authors: U.J. Martinis, V.R. Radovic
• Journal: Diseases of the Chest
• Published: 1965;47:568-70
• Cited by: 7 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. 001532).

Summary of the article

The authors, from the People's Republic of Serbia Tuberculosis Institute in Belgrade, Yugoslavia, reported the case of a 53-year-old man with pulmonary tuberculosis in whom pleural mesothelioma was found only at autopsy. Tuberculosis was diagnosed in January 1961, and he was treated in hospital from February to November 1961. He was re-admitted with fever, cough and acid-fast bacilli in his sputum. The bacilli were resistant to standard drugs. Over the following months he developed rising leukocytosis, enlarged supraclavicular, axillary and inguinal lymph nodes, a prominent left hemithorax, bloody sputum and hemoptysis. Radiographs showed a cavernous left-sided lesion and, later, a semicircular left-sided shadow with the trachea displaced to the right. There was no pleural effusion. Repeated sputum examinations found no malignant cells. The patient refused biopsy, but aspiration of a lymph node showed malignant cells. Leukocyte counts reached 63,500 per mm³, and the bone marrow was normal. He died in extreme cachexia on the 16th day after his last admission. Postmortem examination in May 1962 showed mesothelioma of the visceral and parietal pleurae at the apex of the left lung, with massive multiple lymph node metastasis, and fibrocaseous cavitary tuberculosis in the right apex. Before death, the doctors had suspected bronchial cancer, Pancoast's tumor or leukosis. They had not considered mesothelioma because there was no pleural effusion and the patient had chronic tuberculosis. The authors concluded that the pleura should be considered as a possible origin of malignancy in the differential diagnosis of thoracic diseases. The report did not mention asbestos or the patient's occupation.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This case report from a tuberculosis institute in Belgrade, Yugoslavia, described one man, aged 53, being treated for active, moderately advanced pulmonary tuberculosis. He later developed fever, bloody sputum, and enlarged lymph nodes in the neck, armpits and groin, and X-rays showed a large shadow in the left chest. Sputum tests found no malignant cells, he refused a lymph node biopsy, and there was no fluid around the lung. Malignant cells were later found in a needle sample from a lymph node. He died on the 16th day after his last admission. The autopsy found mesothelioma of the pleura (the lining around the lung) at the top of the left lung, with spread to many lymph nodes, and tuberculosis in the right lung. Before the autopsy the doctors had not thought of mesothelioma. The authors concluded that the case warned them to consider the pleura as a source of cancer when diagnosing chest diseases. The report did not mention asbestos or the man's work.

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
• Who was studied: One man, aged 53, with pulmonary tuberculosis, treated at the People's Republic of Serbia Tuberculosis Institute, Belgrade, Yugoslavia, in 1961 and 1962
• Main results:
  • Enlarged lymph nodes appeared on both sides in the armpits and groin, in addition to nodes above the collarbone.
  • Sputum was checked for malignant cells many times without finding them, and the patient refused a biopsy.
  • There was no pleural effusion (fluid around the lung).
  • Malignant cells were found when peripheral lymph nodes were sampled by aspiration.
  • The patient died in extreme cachexia (severe wasting) on the 16th day after admission.
  • At autopsy, mesothelioma was found in the visceral and parietal pleurae at the apex of the left lung, with massive multiple lymph node metastasis. The histologic diagnosis was mesothelioma of the pleurae.
  • At autopsy, fibrocaseous cavitary tuberculosis was found in the apex of the right lung.
  • Before the autopsy, the doctors suspected cancer of the bronchus with tuberculosis and did not consider mesothelioma, because there was no pleural effusion and the patient had chronic pulmonary tuberculosis.
• The authors' conclusion: The authors concluded that the experience from the autopsy warned them to think of the pleura as the origin of malignant growth when diagnosing diseases of the chest.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Autopsy, Sputum, Hemithorax, Hemoptysis, Pleural Effusion, Biopsy, Cachexia.

Related studies

• Evaluation of ALS assay of TB-SA for diagnosis of pulmonary tuberculosis — J. Jiao, M.S. Wang, et al. (2015)
• Asbestosis and tuberculosis — F. Segarra-Obiol, P. Lopez-Ibañez, et al. (1983)
• Asbestos and tuberculosis in Trieste, Italy — A.M. Walker, G. Stanta, et al. (1985)
• Diffuse mesothelioma of the pleura and asbestos — P.C. Elmes, W.T. McCaughey, et al. (1965)
• The pathology of mesotheliomata and an analysis of their association with asbestos exposure — D.O. Hourihane (1964)
• Diffuse mesothelioma and exposure to asbestos dust in the Merseyside area — W.G. Owen (1964)

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