Rapid growth of a pleural mesothelioma

Our plain-English summary of Rapid growth of a pleural mesothelioma, by G.C. Lulenski, R. Pifarré, W.E. Neville (Chest, 1971).

The study

• Authors: G.C. Lulenski, R. Pifarré, W.E. Neville
• Journal: Chest
• Published: 1971;59(2):230-2
• Cited by: 7 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. 001364).

Abstract

A patient with diffuse pleural mesothelioma presenting as a large mass in the left hemithorax is described. Despite a normal chest roentgenogram three months earlier and symptoms of only three days' duration, the patient expired within three weeks of admission. This confirms the potential rapid growth of this malignancy.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This case report described one patient with diffuse pleural mesothelioma at a Veterans Administration hospital in Hines, Illinois. The patient was a 46-year-old man with bullous emphysema. He had worked as an oil drum packer from 1950 to 1957 and was exposed to insulating materials including asbestos. The article did not say which fiber type this patient was exposed to. After lung surgery in April 1969, a follow-up chest film was read as normal apart from pleural symphysis, emphysema and fibrosis. About three months later, in July 1969, he was admitted with three days of worsening shortness of breath; an X-ray showed a large left chest mass. Surgery found a mass filling the left pleural space and invading the chest wall and lung. A frozen section was read as undifferentiated carcinoma, but the Armed Forces Institute of Pathology reported findings favoring mesothelioma. The patient died on the 16th day after surgery; no autopsy was allowed. The authors concluded that a short history of symptoms or a recent normal chest X-ray did not rule out this tumor type.

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 (one patient)
• Who was studied: One 46-year-old man (described in the article as Negro) with a long history of bullous emphysema, admitted to the Veterans Administration Hospital, Hines, Illinois, on July 22, 1969
• Exposure: Work as an oil drum packer from 1950 to 1957, with exposure to a variety of insulating materials including asbestos. The article gave no fiber type or dose for this patient. It names fibers (crocidolite, amosite and a third printed as 'crysolite') only in its general background on mesothelioma.
• Main results:
  • After a right upper lobectomy in April 1969, a follow-up chest film taken two weeks after discharge was read as normal except for pleural symphysis, emphysema and fibrosis.
  • The patient presented with shortness of breath three days before a scheduled three-month follow-up. A chest X-ray showed a large mass in the left hemithorax with a fluid level.
  • A chest tube drained 750 ml of serosanguinous fluid. Cultures were negative, and cytology was later reported positive for malignant cells.
  • At thoracotomy, the mass extended from the left apex to the diaphragm. It directly invaded much of the left chest wall and the lung, and it could not be removed.
  • The frozen section was reported as undifferentiated carcinoma. The Armed Forces Institute of Pathology later reported findings that favored mesothelioma, including hyaluronic acid between the tumor cells.
  • The patient died on the 16th postoperative day. The whole course lasted slightly less than four months from the last normal chest X-ray and less than one month from the onset of symptoms.
• The authors' conclusion: The authors concluded that a short duration of symptoms or a recent normal chest X-ray does not rule out this type of malignancy as a cause of chest pain or shortness of breath. They described the case as an example of the rapid growth of the diffuse type of pleural mesothelioma.
• Limitations the authors state:
  • The authors reported that no autopsy was performed because permission was not granted.
  • The authors reported that asbestos bodies were not looked for in the earlier lobectomy tissue.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Hemithorax.

Related studies

• Rapid growth of malignant pleural mesothelioma — K. Kaira, K. Dobashi, et al. (2007)
• Inhibition of lung injury, inflammation, and interstitial pulmonary fibrosis by polyethylene glycol-conjugated catalase in a rapid inhalation model of asbestosis — B.T. Mossman, J.P. Marsh, et al. (1990)
• Rapid target gene validation in complex cancer mouse models using re-derived embryonic stem cells — I.J. Huijbers, R. Bin Ali, et al. (2014)
• Rapid activation of PDGF-A and -B expression at sites of lung injury in asbestos-exposed rats — J.Y. Liu, G.F. Morris, et al. (1997)
• Rapid and easy method for monitoring oxidative stress markers in body fluids of patients with asbestos or silica-induced lung diseases — K. Syslová, P. Kacer, et al. (2009)
• Rapid short-term clearance of chrysotile compared with amosite asbestos in the guinea pig — A. Churg, J.L. Wright, et al. (1989)

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