Primary malignant pericardial mesothelioma mimicking pericardial metastasis from adenocarcinoma

Our plain-English summary of Primary malignant pericardial mesothelioma mimicking pericardial metastasis from adenocarcinoma, by M. Horie, S. Noguchi, W. Tanaka, et al (Journal of Thoracic Oncology, 2010).

The study

• Authors: M. Horie, S. Noguchi, W. Tanaka, H. Yoshihara, M. Kawakami, M. Suzuki, Y. Sakamoto, T. Oka
• Journal: Journal of Thoracic Oncology
• Published: 2010;5(12):2012-4
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This case report, published as an "Image of the Month" by doctors at Kanto Central Hospital in Tokyo, described one patient. An 85-year-old man, a retired school teacher without obvious history of asbestos exposure, had breathlessness on exertion and fatigue. Fluid around the heart (pericardial effusion) was drained. Its hyaluronic acid level was within the normal range, and cell examination suggested adenocarcinoma. A PET scan showed abnormal uptake around the pericardium and major vessels but no primary tumor. Pleural thickening and pleural plaques were not detected. He was diagnosed with metastatic adenocarcinoma of unknown origin and died about 3 months later of right heart failure from constrictive pericarditis. At autopsy, tumor had invaded the pericardium and heart muscle but was not found in the pleura. Pleural plaques were found, but no asbestos bodies were seen. Tissue findings and calretinin staining led to a diagnosis of diffuse, biphasic primary malignant pericardial mesothelioma, meaning it contained both epithelioid and spindle-shaped cells. The authors concluded that tissue and immunohistochemical studies should be performed when this disease is suspected, even if fluid cytology suggests adenocarcinoma.

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 (single patient, "Image of the Month" item)
• Who was studied: one 85-year-old man, a retired school teacher, seen at Kanto Central Hospital, Tokyo, Japan
• Exposure: no obvious history of asbestos exposure; at autopsy pleural plaques were found but asbestos bodies were not observed
• Main results:
  • The pericardial effusion had a hyaluronic acid level of 32,000 ng/ml, described as within the normal range
  • Cytology of the pericardial fluid was positive and suggested adenocarcinoma
  • PET scan showed abnormal aggregations around the ascending aorta, pulmonary artery and pericardium, but no primary focus was found
  • Before death, pleural thickening and pleural plaques were not detected
  • The patient died about 3 months after diagnosis from right cardiac failure due to constrictive pericarditis
  • At autopsy, tumor was not found in the pleura
  • At autopsy, pleural plaques were found but asbestos bodies were not observed
  • Calretinin staining was positive in the epithelioid and sarcomatous tumor cells
  • Final diagnosis was diffuse and biphasic primary malignant pericardial mesothelioma
• The authors' conclusion: The authors concluded that histologic and immunohistochemical studies should be performed when primary malignant pericardial mesothelioma is clinically suspected, even if pericardial effusion cytology indicates adenocarcinoma

Topics

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

Medical terms in this study, explained in our Lexicon: Pericardial Mesothelioma, Pericardial, Metastasis, Adenocarcinoma.

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