Pseudomesotheliomatous carcinoma of the lung with asbestos exposure

Our plain-English summary of Pseudomesotheliomatous carcinoma of the lung with asbestos exposure, by J. Simonsen (The American Journal of Forensic Medicine and Pathology, 1986).

The study

• Author: J. Simonsen
• Journal: The American Journal of Forensic Medicine and Pathology
• Published: 1986;7(1):49-51
• Type of article: Case report
• Cited by: 12 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. 001143).

Abstract

A case of peripheral lung carcinoma clinically and anatomically simulating a malignant mesothelioma in a man who had been exposed to silicium as well as asbestos during more than 20 years of employment in industry is presented. Results of the microscopic examination of routine, stained sections were inconclusive and the importance of demonstrating mucin in the neoplastic cells by use of special staining is emphasized.

In plain English

This article was a case report from Denmark. It described a 69-year-old blacksmith who had worked 22 years at an iron foundry, not directly in founding, and then one year at a gasworks. The article stated that he had been exposed to silicium as well as asbestos for more than 20 years at work. No asbestos fiber type was given. He smoked cigarettes and a pipe. A chest x-ray raised suspicion of silicosis and of a process in the lower part of the right lung. After his death, the autopsy found firm whitish tissue up to 2 cm thick encasing the right lung, and malignant mesothelioma was tentatively diagnosed. Microscopy instead found a bronchoalveolar carcinoma in a 3 cm area beneath the lung surface. Special staining showed mucin in the tumor cells in all sections, and the final diagnosis was modified. The author concluded that special staining for mucin helps tell such lung cancers apart from mesothelioma. The author also stated that so far there were no indications that this tumor type is related to inhaling asbestos or silicium.

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, including autopsy findings)
• Who was studied: one 69-year-old blacksmith in Denmark who worked 22 years at an iron foundry (not directly in founding), then 1 year at a gasworks; he smoked cigarettes and a pipe
• Exposure: occupational exposure to silicium as well as asbestos for more than 20 years in industry; no fiber type, products or doses given
• Main results:
  • The chest x-ray raised suspicion of a process in the basal part of the right lung, and of silicosis
  • Pleural aspiration samples showed no malignant cells. Mediastinoscopy found tumor tissue with adenomatous formations
  • At autopsy, tissue up to 2 cm thick encased the right lung
  • A small white cotton-like process 3 cm in diameter was found beneath the pleural surface in the right lower lobe
  • Diffuse lung fibrosis was noted, but there were no silicotic or tumorous changes in the hilar lymph nodes
  • Because of the asbestos exposure history and the gross appearance, a tentative diagnosis of malignant mesothelioma was made
  • Histology of the cotton-like area showed a bronchoalveolar carcinoma. Special staining showed mucin in the tumor cells in all sections, and the final diagnosis was modified
  • The cause of death was the malignant process in the right chest cavity together with inflammatory changes in the lungs
  • In the discussion, the author stated that so far there were no indications that this tumor type is related to inhaling asbestos or silicium
• The authors' conclusion: The author concluded that special staining for mucin (mucicarmine, alcian blue, or periodic acid-Schiff) is most helpful in correctly classifying such cases, and that pathologists evaluating occupational lung diseases need to know this tumor type exists

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, Asbestos Exposure, Carcinoma, Malignant Mesothelioma.

Related studies

• 'Pseudomesotheliomatous' carcinomas of the pleura: a 10-year analysis of cases from the Environmental Lung Disease Research Group, Cardiff — R.L. Attanoos, A.R. Gibbs (2003)
• Pseudomesotheliomatous carcinoma of the lung. A variant of peripheral lung cancer — T.R. Harwood, D.R. Gracey, et al. (1976)
• Pseudomesotheliomatous carcinoma involving pleura and peritoneum: A clinicopathologic and immunohistochemical study of three cases — I.A. Shah, J.R. Salvatore, et al. (1999)
• Pseudomesotheliomatous carcinoma of the pleura: an autopsy case of metastasis from a G-CSF-producing anaplastic carcinoma of the pancreas — Y. Hattori, K. Sentani, et al. (2018)
• The importance of retaining post mortem tissue--'pseudomesotheliomatous' Merkel cell carcinoma of the pleura — G.D. Leopold, R.L. Attanoos (2011)
• Pseudomesotheliomatous small-cell neuroendocrine carcinoma of the lung with calretinin expression — G.D. Exarchos, R.L. Attanoos (2015)

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