Primary pleural epithelioid mesothelioma of clear cell type: a case report and review of current literature

Our plain-English summary of Primary pleural epithelioid mesothelioma of clear cell type: a case report and review of current literature, by C. Gkogkou, K. Samitas, M. Foteinou (Ultrastructural Pathology, 2011).

The study

• Authors: C. Gkogkou, K. Samitas, M. Foteinou
• Journal: Ultrastructural Pathology
• Published: 2011;35(6):267-70
• Type of article: Case report, Review
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Primary pleural epithelioid mesothelioma with clear cell morphology is a particularly rare neoplasm, with only a few documented cases. Here, the authors report a case of a 76-year-old man, with a history of asbestos exposure, admitted for mild dyspnea. Radiologic examination revealed right pleural effusion and pleural thickening. Cytological examination of aspirated pleural samples was consistent with non-small cell carcinoma. Histological examination of the resected, via VATS, plural specimens was consistent with the diagnosis of clear cell epithelioid mesothelioma. The authors further analyze the main morphological and immunohistochemical features of clear cell epithelioid mesothelioma, emphasizing the algorithm for excluding other clear cell tumors metastatic to the pleura.

In plain English

This article was a case report of one patient, followed by the authors' discussion of published literature on telling this rare tumor apart from other clear cell tumors that spread to the pleura. The patient was a 76-year-old man, a nonsmoker with a history of occupational exposure to asbestos. The article did not name the fiber type or the job. CT scans showed thickening of the pleura (the chest lining) at the lower right lobe and fluid around the right lung. Cells in the drained fluid were consistent with non-small cell carcinoma. Tissue taken by video-assisted thoracoscopy (VATS) showed a malignant tumor in the parietal pleura, made of cells with mostly clear cytoplasm. The cells stained positive for markers including calretinin, HBME-1, vimentin, EMA and CD10. They were negative for markers including CEA, TTF-1, P63 and cytokeratin 5/6. The final diagnosis was primary clear cell epithelioid mesothelioma. The authors stated that this diagnosis rested mainly on excluding other tumors. A single case report describes what happened to one person and does not show how often this occurs.

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 with a review of the literature on diagnosis
• Who was studied: one 76-year-old man, a nonsmoker with no history of heart or lung disease, who sought care for chest pain, dyspnea and persistent cough
• Exposure: a history of occupational asbestos exposure. Fiber type, job and duration are not given.
• Main results:
  • CT showed pleural thickening at the lower right lobe with a right pleural effusion
  • cells in the aspirated pleural fluid were consistent with non-small cell carcinoma
  • VATS biopsies showed the parietal pleura infiltrated by an undifferentiated malignant tumor of epithelioid cells with mostly clear cytoplasm
  • the tumor cells were positive for HBME-1, vimentin, EMA, P53, calretinin, CD10, AE1/AE3 and cytokeratin 18
  • the tumor cells were negative for cytokeratin 5/6, P63, cytokeratin 20, thrombomodulin, RCCMa, Tag-72, LeuM1, CEA, TTF-1, HMB45, smooth muscle actin, LCA and CD30
  • the cells stained for PAS but not for PAS-D or Alcian blue
  • the final diagnosis was primary clear cell epithelioid mesothelioma
• The authors' conclusion: The authors stated that the diagnosis of mesothelioma in this case was based mainly on excluding the other tumors considered.

Topics

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

Medical terms in this study, explained in our Lexicon: Epithelioid, Mesothelioma, Neoplasm, Asbestos Exposure, Dyspnea, Pleural Effusion, Pleural Thickening, Carcinoma.

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