Primary pericardial mesothelioma following exposure to asbestos

Our plain-English summary of Primary pericardial mesothelioma following exposure to asbestos, by E.I. Kahn, A. Rohl, E.W. Barrett, et al (Environmental Research, 1980).

The study

• Authors: E.I. Kahn, A. Rohl, E.W. Barrett, Y. Suzuki
• Journal: Environmental Research
• Published: 1980;23(2):270-81
• Cited by: 21 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. 000819).

In plain English

This article was a case report about one patient, a 60-year-old white man admitted to North Shore University Hospital in New York on May 31, 1978, with weight loss and a left pleural effusion (fluid around the left lung). The patient was a nonsmoker who had been exposed to asbestos while working in shipyards during World War II, 30 years before admission. The patient died in hospital. At autopsy, a tumor filled the sac around the heart (the pericardium) and encased the heart. The authors identified it as a pericardial mesothelioma with a sarcomatous pattern and found no primary site outside the pericardium. The autopsy also showed pleural fibrosis, large pleural plaques on both halves of the diaphragm, and ferruginous bodies in both lungs, but no significant pulmonary fibrosis. Electron microscopy showed a heavy lung burden of particles, mostly consistent with quartz and feldspars, along with amosite asbestos fibers. The authors concluded that the case provided strong evidence for an asbestos-induced mesothelioma arising in the pericardium. They acknowledged that the findings could be read as coincidental, that ferruginous bodies are not specific to asbestos, and that small foci of tumor in the pleura can be overlooked.

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, with clinical history and autopsy findings)
• Who was studied: one 60-year-old white male nonsmoker admitted to North Shore University Hospital, Manhasset, New York, on May 31, 1978
• Exposure: asbestos exposure while working in shipyards during World War II, 30 years before admission; amosite fibers were later found in lung tissue
• Main results:
  • At autopsy, a diffuse tumor mass filled the pericardial cavity and completely encased the heart
  • The pericardial tumor had a sarcomatous pattern under the microscope
  • No primary tumor site was found outside the pericardium
  • Large pleural plaques were found on both hemidiaphragms
  • Ferruginous bodies were found in both lungs
  • No significant pulmonary fibrosis was found
  • Electron microscopy of lung tissue showed a heavy to very heavy burden of inorganic particles
  • Most of the lung particles had chemistries consistent with quartz and feldspars
  • Amphibole asbestos fibers identified as amosite were also seen in the lung tissue
  • The authors attributed the patient's death to congestive heart failure caused by the bulky tumor around the heart, complicated by lack of oxygen to the brain
• The authors' conclusion: The authors concluded that the case provided strong evidence for an asbestos-induced mesothelioma arising in the pericardium
• Limitations the authors state:
  • The authors acknowledged that the tumor and the signs of asbestos exposure could be interpreted as coincidental
  • The authors noted that ferruginous bodies seen by light microscopy are not specific to asbestos
  • The authors noted that microscopic foci of tumor in the pleura can be overlooked, although the pleura was sampled

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.

Related studies

• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Primary pericardial tumors — C.S. Restrepo, D. Vargas, et al. (2013)
• Primary pericardial mesothelioma: report of two cases and review of the literature — A.L. Sytman, R.N. MacAlpin (1971)
• Primary pericardial mesothelioma — N.T. Eren, A.R. Akar (2002)
• Treatment and Outcomes of Primary Pericardial Mesothelioma: A Contemporary Review of 103 Published Cases — E. McGehee, D.E. Gerber, et al. (2019)
• A case of primary pericardial mesothelioma detected by 18F-FDG PET/CT — F. Aga, Y. Yamamoto, et al. (2012)

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