Pseudomesotheliomatous carcinoma of lung adenocarcinoma diagnosed using transesophageal ultrasound-guided bronchoscopic aspiration

Our plain-English summary of Pseudomesotheliomatous carcinoma of lung adenocarcinoma diagnosed using transesophageal ultrasound-guided bronchoscopic aspiration, by T. Sumi, H. Nakata, Y. Mori, et al (Thoracic Cancer, 2021).

The study

• Authors: T. Sumi, H. Nakata, Y. Mori, H. Chiba
• Journal: Thoracic Cancer
• Published: 2021;12(9):1465-1466
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA), a minimally invasive procedure, may be useful for the diagnosis of pseudomesotheliomatous (PMC) carcinoma because a sufficient amount of tissue can be obtained for diagnosis. This is the first report of PMC diagnosed using EUS-B-FNA. Our findings suggest that EUS-B-FNA may reduce the risk of dissemination for PMC.

© 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

In plain English

This case report from Japan describes a 66-year-old man admitted with shortness of breath. A CT scan showed fluid and thickening of the left pleura, with no tumor visible inside the lung; the thickening was confined to the parietal pleura, the layer lining the chest wall. The imaging suggested malignant pleural mesothelioma, but a test of the fluid for cancer cells was negative. To minimize what the authors called chest wall invasion, doctors sampled the thickened pleura with an ultrasound-guided needle passed through the esophagus (EUS-B-FNA). Laboratory testing showed lung adenocarcinoma, not mesothelioma: the tumor cells were positive for TTF-1 and negative for calretinin and WT-1. The man was diagnosed with stage IVA pseudomesotheliomatous carcinoma, a lung cancer that spreads along the pleura like mesothelioma, and chemotherapy was started. The article does not mention asbestos exposure. The authors concluded that EUS-B-FNA may be useful for diagnosing this cancer because it is minimally invasive and yields enough tissue. Citing earlier studies, they suggested it may lower the risk of tumor spread, which this case did not measure.

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, brief imaging report)
• Who was studied: one 66-year-old man admitted with shortness of breath, treated at Hakodate Goryoukaku Hospital, Hakodate, Japan; dates of care not given
• Exposure: No asbestos or other exposure history is reported. The article concerns a diagnostic procedure: ultrasound-guided needle aspiration of the thickened pleura through the esophagus (EUS-B-FNA).
• Main results:
  • In this patient, CT showed fluid and pleural thickening on the left side
  • In this patient, no tumor was seen inside the lung on CT
  • In this patient, the pleural thickening was confined to the left parietal pleura
  • In this patient, the imaging findings suggested malignant pleural mesothelioma
  • In this patient, testing of the pleural fluid for cancer cells (cytology) was negative
  • In this patient, the needle sample of the thickened pleura was diagnosed as lung adenocarcinoma
  • In this patient, the tumor cells expressed TTF-1 but not calretinin or WT-1
  • The authors described pseudomesotheliomatous carcinoma (PMC) as peripheral lung cancer that infiltrates the pleura in a mesothelioma-like manner
  • The patient was diagnosed with PMC of lung adenocarcinoma, stage cTXN0M1a IVA
  • In this patient, no driver gene mutations were found and chemotherapy was started
  • The authors suggested, citing earlier studies of other biopsy methods and of pancreatic cancer, that EUS-B-FNA may also reduce the risk of tumor spread in PMC; this was not measured in this case
  • The authors stated they knew of no earlier reports of PMC diagnosed by EUS-B-FNA
• The authors' conclusion: The authors concluded that EUS-B-FNA may be useful for diagnosing PMC because it is minimally invasive and a sufficient amount of tissue can be obtained for diagnosis.

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: Pseudomesotheliomatous Adenocarcinoma, Lung Adenocarcinoma, Ultrasound, Fine-Needle Aspiration, Carcinoma.

Related studies

• Endobronchial ultrasound-guided transbronchial needle aspiration with the flexible 19-gauge needle — R. Trisolini, F. Natali, et al. (2018)
• Endoscopic Ultrasound with Bronchoscope-Guided Fine Needle Aspiration for the Diagnosis of Paraesophageally Located Lung Lesions — I. Skovgaard Christiansen, J.C. Kuijvenhoven, et al. (2019)
• "Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) — F. Lococo, G. Rossi, et al. (2014)
• Endoscopic ultrasound-guided fine needle aspiration of a pericardial mass — P. Somani, M. Sharma, et al. (2016)
• Isolated pancreatic metastasis from a malignant pleural mesothelioma diagnosed using endoscopic ultrasonography-guided fine needle aspiration biopsy — Y. Ishikawa-Kakiya, H. Maruyama, et al. (2022)
• Endobronchial ultrasound-guided transbronchial needle aspiration in a patient with pericardial mesothelioma — H. Ashinuma, M. Shingyoji, et al. (2015)

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