Pleural sarcomatoid mesothelioma with an interstitial growth pattern

Our plain-English summary of Pleural sarcomatoid mesothelioma with an interstitial growth pattern, by K. Miyakawa, M. Yamamoto, N. Akiyama, et al (Pathology International, 2020).

The study

• Authors: K. Miyakawa, M. Yamamoto, N. Akiyama, M. Sado, S. Yuzawa, A. Okizaki, Y. Nishikawa, H. Takei, M.A. Tanino
• Journal: Pathology International
• Published: 2020;70(2):126-128
• Type of article: Case report, Letter
• Read it: PubMed · Publisher

In plain English

This letter to the editor described one autopsied case of pleural sarcomatoid mesothelioma from Japan. A 62-year-old man had shortness of breath on exertion and a persistent cough. He had worked in a cement/concrete plant and a paper mill, which the authors said suggested asbestos exposure. The article does not name a fiber type. Scans showed fluid around the lung and thickened left pleura. He was diagnosed with malignant pleural mesothelioma from scans and fluid cells and treated with carboplatin and pemetrexed chemotherapy. The disease progressed, and he died 6 months after admission. At autopsy, the tumor encased the lung as a rind. Its cells spread from the pleura into the thin walls between the lung's air sacs without destroying them, which the authors called an 'interstitial growth pattern'. A few asbestos bodies were found in the lung, and the tumor had spread to several groups of lymph nodes. The authors stated that this pattern had not been reported in malignant pleural mesothelioma. They concluded that it may imply tumor aggressiveness, as in this patient.

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) of a single autopsied patient
• Who was studied: One 62-year-old man with shortness of breath on exertion and persistent cough; the authors are based at hospitals and universities in Hokkaido and Yamagata, Japan
• Exposure: Work in a cement/concrete plant and a paper mill, which the authors said suggested asbestos exposure; no fiber type or dose given; a few asbestos bodies were found in the lung at autopsy
• Main results:
  • At autopsy, tumor cells invaded the walls of the lung's air sacs without filling the air spaces, a pattern the authors called the 'interstitial growth pattern'
  • The authors stated that this interstitial growth pattern has not been reported in malignant pleural mesothelioma
  • A few asbestos bodies were seen in the patient's lung tissue
  • The pleural fluid had a hyaluronic acid concentration of 56 000 ng/mL
  • Despite chemotherapy, the patient died 6 months after admission
  • Tumor tissue staining: calretinin and CK5/6 were focally positive; BAP1 loss was not seen; Ki-67 labeling index was about 20%
  • The tumor had spread to several groups of lymph nodes, but no distant metastases or other primary tumors were seen
• The authors' conclusion: The authors concluded that the interstitial growth pattern may imply tumor aggressiveness, as shown in this case

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: Sarcomatoid, Mesothelioma, Interstitial.

Related studies

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• Monocyte-derived growth factors in asbestos-induced interstitial fibrosis — D.A. Schwartz, L. Rosenstock, et al. (1989)
• Connective tissue growth factor and β-catenin constitute an autocrine loop for activation in rat sarcomatoid mesothelioma — L. Jiang, Y. Yamashita, et al. (2014)
• Prognostic significance of morphological growth patterns and mitotic index of epithelioid malignant peritoneal mesothelioma — A.M. Krasinskas, A.C. Borczuk, et al. (2016)
• Presence of pleomorphic features but not growth patterns improves prognostic stratification of epithelioid malignant pleural mesothelioma by 2-tier nuclear grade — Y.Z. Zhang, C. Brambilla, et al. (2020)
• Malignant pleural mesothelioma mimicking the intrapulmonary growth pattern of epithelioid hemangioendothelioma — Y. Muramatsu, K. Isobe, et al. (2014)

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