Pleural mesothelioma presenting as recurrent pneumothoraces

Our plain-English summary of Pleural mesothelioma presenting as recurrent pneumothoraces, by R.J. Bright-Thomas, R.Y. Ahmed, S.B. Pearson, et al (British Journal of Hospital Medicine, 2010).

The study

• Authors: R.J. Bright-Thomas, R.Y. Ahmed, S.B. Pearson, M.F. Muers, A.R. Luksza, P.M. Turkington
• Journal: British Journal of Hospital Medicine
• Published: 2010;71(10):590-1
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This case report described five men with pleural mesothelioma whose illness first appeared as a pneumothorax (a collapsed lung) that kept coming back. They were aged 41 to 79 and were seen in different hospital respiratory departments. All had worked with asbestos. Their jobs were shipwright for 40 years, shipyard burning machinist for 32 years, insulating catering equipment with asbestos in the steel industry, electrician, and painter and decorator. The article did not name fiber types. In three men the first chest X-ray showed no pleural thickening, fluid or plaques. Mesothelioma was confirmed by tissue examination after surgery or biopsy in four men and at post-mortem in one. In one man, the pleural tissue examined first showed only reactive cells, which were thought to be caused by talc treatment, and mesothelioma was found a year later. One man died 4 months after surgery. The authors wrote that in all five cases diagnosis was delayed because mesothelioma was not considered at first and no work history was taken. They concluded that mesothelioma should be considered in patients over 40 who present with spontaneous pneumothorax.

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 (series of five cases)
• Who was studied: Five men with pleural mesothelioma, aged 79, 76, 41, 63 and 45, seen in different respiratory departments; dates and exact locations of the cases are not given
• Exposure: Occupational asbestos exposure; fiber types not stated. Jobs: shipwright for 40 years; burning machinist in a shipyard for 32 years; insulating catering equipment with asbestos in the steel industry 15 to 20 years earlier; electrician 30 years earlier; painter and decorator
• Main results:
  • Case 1 (79-year-old man): the pleura looked normal at surgery, but tissue examination showed an epithelial-type malignant mesothelioma; he died 4 months after pleurectomy
  • Case 2 (76-year-old man, with pleural plaques on X-ray): pleural fluid and biopsy gave no definitive diagnosis; a presumed diagnosis of mesothelioma was confirmed at post-mortem
  • Case 3 (41-year-old man): malignant mesothelioma was confirmed after thoracotomy and pleurectomy
  • Case 4 (63-year-old man): pleural fluid showed no malignant cells, but tissue examination after thoracotomy showed a malignant mesothelioma
  • Case 5 (45-year-old man): the first pleural tissue showed reactive mesothelial cells thought to be caused by talc pleurodesis; a year later, biopsy found an epithelioid malignant mesothelioma
  • In cases 3, 4 and 5 the first chest X-ray showed no pleural thickening, fluid or plaques
  • The authors stated that diagnosis was delayed in all five patients because mesothelioma was not considered at presentation and occupational history was not taken
• The authors' conclusion: The authors concluded that mesothelioma should be considered as a diagnosis in patients over 40 presenting with spontaneous pneumothoraces, that an occupational history should be taken, and that more definitive tests such as thoracoscopy are recommended if the pneumothorax recurs

Topics

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

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

Related studies

• Intrapleural talc for the prevention of recurrent pneumothorax — J.R. Milanez, F.S. Vargas, et al. (1994)
• Recurrent pneumothorax: an unusual presentation of malignant mesothelioma — S.I. Handa, A.G. Wilkinson (1989)
• Recurrent pneumothorax following abdominal paracentesis — P.J. Stafford (1990)
• Malignant pleural mesothelioma presenting as spontaneous pneumothorax: a case series and review — S. Alkhuja, A. Miller, et al. (2000)
• Recurrent hydropneumothorax as a presenting feature of malignant mesothelioma — K. Guha, D. Jones, et al. (2008)
• Lepidic intrapulmonary growth of malignant mesothelioma presenting as recurrent hydropneumothorax — H. Wu, G. Tino, et al. (1996)

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