Pleural small cell carcinoma in pre-existent asbestos related pleural disease

Our plain-English summary of Pleural small cell carcinoma in pre-existent asbestos related pleural disease, by H.F. van der Heijden, Y.F. Heijdra, J. Bulten, et al (Lung Cancer, 2002).

The study

• Authors: H.F. van der Heijden, Y.F. Heijdra, J. Bulten, J. Festen
• Journal: Lung Cancer
• Published: 2002;35(1):91-4
• Type of article: Case report
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Extrapulmonary small cell carcinoma (SCC) is a very rare disease, and a primary pleural manifestation is extremely rare. A case of SCC of the pleura in a 66-year-old man with pre-existent asbestos-related pleural plaques is presented. This is the first case of pleural SCC in a patient with asbestos-induced pleural disease and the third reported case of a pleural SCC. The SCC developed in an area with pre-existent pleural thickening, underlining the need for careful analysis of alterations in the manifestation of pleural disease in patients with asbestos exposition.

In plain English

This case report from the Netherlands described a 66-year-old man referred for left-sided chest pain. He had worked as a carpenter in buildings and ships, remembered at least one incident of unprotected asbestos contact, and had smoked 40 pack years. Chest X-rays showed calcified pleural thickening, pleural plaques on the diaphragm, and a left-sided pleural mass that had grown since earlier films. The authors noted this mass was the only pleural abnormality that had changed over 17 years of chest X-rays. A biopsy showed small cell carcinoma of the pleura. Staining did not fit mesothelioma, and no lung tumour or distant spread was found. The man died at home 11 days after starting chemotherapy, and no autopsy was allowed. The authors described this as, to their knowledge, the first reported pleural small cell carcinoma in a patient with asbestos-related pleural disease. They stated they lacked sufficient data to show a direct causal link between the pleural thickening and the cancer. They concluded that the case underlines the need for careful analysis of radiological (imaging) changes in patients with asbestos-related pleural abnormalities.

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 (one patient)
• Who was studied: one 66-year-old man referred to the pulmonary department of University Medical Center St. Radboud, Nijmegen, the Netherlands; dates of care not stated
• Exposure: occupational asbestos contact as a carpenter in buildings and ships, with at least one remembered incident of unprotected asbestos contact; fiber type and dose not stated. He had also smoked 40 pack years and had stopped 6 months before referral.
• Main results:
  • Chest X-ray showed a left lateral pleural mass over the 7th and 8th ribs that had increased in size compared with earlier films, alongside calcified pleural thickening and pleural plaques on the diaphragm
  • The mass was the only pleural abnormality that had changed in 17 years of consecutive chest X-rays; it became visible 6 months before referral
  • Surgical biopsy gave a diagnosis of small cell carcinoma of intermediate type located at the pleura
  • The immunohistochemical features did not fit mesothelioma
  • No tumour was found in the lung and no distant metastases were found
  • The patient died at home 11 days after starting chemotherapy; a post-mortem examination was not allowed
• The authors' conclusion: The authors described this as, to their knowledge, the first reported case of pleural small cell carcinoma in a patient with asbestos-related pleural disease, and concluded that it underlines the need for careful analysis of radiological changes in patients with asbestos-related pleural abnormalities
• Limitations the authors state:
  • The authors stated they did not have sufficient data to show a direct causal relation between the pleural thickening and the cancer developing at the same location, because earlier CT scans were not available

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Pleura, Pleural Plaques, Pleural Thickening.

Related studies

• Pleural small cell carcinoma with massive pleural effusion: A case report — J.G. Jang, M.H. Jang, et al. (2019)
• Extrapulmonary small cell carcinoma — H.F. van der Heijden, Y.F. Heijdra (2005)
• Extrapulmonary small cell carcinoma mimicking malignant pleural mesothelioma — K. Noguchi, N. Fujimoto, et al. (2013)
• Etiology of small cell lung carcinoma — W.J. Zeller, D. Schmähl (1985)
• Nuclear Brachyury Expression Is Consistent in Chordoma, Common in Germ Cell Tumors and Small Cell Carcinomas, and Rare in Other Carcinomas and Sarcomas: An Immunohistochemical Study of 5229 Cases — M. Miettinen, Z. Wang, et al. (2015)
• Collision tumour of the pleura composed of small cell carcinoma and malignant mesothelioma — A.H. Lee, I.N. Soomro (2004)

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