Pseudomesotheliomatous small-cell neuroendocrine carcinoma of the lung with calretinin expression

Our plain-English summary of Pseudomesotheliomatous small-cell neuroendocrine carcinoma of the lung with calretinin expression, by G.D. Exarchos, R.L. Attanoos (Histopathology, 2015).

The study

• Authors: G.D. Exarchos, R.L. Attanoos
• Journal: Histopathology
• Published: 2015;66(6):895-6
• Type of article: Case report, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor was a case report from two pathologists at the University Hospital of Wales, Cardiff. It described a 78-year-old boiler worker with established asbestos exposure who had been clinically diagnosed with asbestosis but deteriorated rapidly before his death. At post mortem, a diffuse mass ran along the lining of the left chest cavity and between the lung lobes, with no significant tumour inside the lung. This growth pattern can mimic mesothelioma. The other pleural cavity had multiple pleural plaques, and both lungs showed subpleural honeycombing. Microscopy and immunohistochemical staining identified the tumour as small-cell neuroendocrine carcinoma of the lung. It stained positive for calretinin, a recognised mesothelial marker, and negative for WT1. Electron microscopy found an amphibole fibre count below the asbestosis range. The authors stated that this did not support inhalation of enough amphibole asbestos to cause asbestosis or lung cancer, and that pleural plaques alone were not enough to attribute a lung cancer to asbestos. They concluded that the case showed the importance of careful pathological examination.

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 (letter to the editor)
• Who was studied: one 78-year-old boiler worker who had been clinically diagnosed with asbestosis and was examined at post mortem; the authors were at the University Hospital of Wales, Cardiff, UK
• Exposure: established asbestos exposure as a boiler worker; fibre type of the exposure not specified; electron microscopy measured retained amphibole fibres
• Main results:
  • Post mortem found a diffuse serosal-based mass in the left hemithorax extending along the interlobar fissures, with no significant tumour inside the lung
  • The opposite pleural cavity contained multiple pleural plaques, and both lungs showed subpleural honeycombing
  • Tumour cells were strongly positive for AE1/AE3, synaptophysin and calretinin (a recognised first-line mesothelial marker), focally positive for TTF-1 and chromogranin-A, and negative for CD45, CD20, CD3 and WT1
  • The tumour was considered to be small-cell neuroendocrine carcinoma of the lung
  • Transmission electron microscopy with energy dispersive X-ray spectrometry showed an amphibole fibre count below the asbestosis range
  • The authors stated that the mineral analysis did not support the view that the man had inhaled enough amphibole asbestos to induce asbestosis or lung cancer
  • The authors stated that pleural plaques alone are an insufficient basis to attribute a lung cancer to asbestos on a balance of probabilities
• The authors' conclusion: The authors concluded that the case highlights the importance of careful pathological examination, rather than relying on clinical diagnosis without post mortem or on post mortem macroscopic interpretation without histology

Topics

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

Medical terms in this study, explained in our Lexicon: Carcinoma, Calretinin.

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