Roentgen aspects of pleural mesothelioma

Our plain-English summary of Roentgen aspects of pleural mesothelioma, by N. Finby, I. Steinberg (Radiology, 1955).

The study

• Authors: N. Finby, I. Steinberg
• Journal: Radiology
• Published: 1955;65(2):169-82
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Five cases of localized pleural mesothelioma and 7 of diffuse pleural mesothelioma are presented. Localized pleural mesothelioma is usually a benign disease but may prove to be the early stage of the diffuse malignant type. Roentgenographically, it is manifest as a circumscribed lobulated mass in the plane of the pleura which cannot be differentiated from other intrathoracic tumors. Angiocardiography aids in demonstrating pericardial and great vessel involvement. Clinically, osteoarthropathy is a common feature. The diagnosis can be made only after thoracotomy and microscopic study of the tumor. Prompt surgical therapy with complete removal of the tumor may be curative. Diffuse pleural mesothelioma, on the other hand, is always a malignant disease. Roentgenographically, it often appears initially as a massive pleural effusion. Pneumothorax, after removal of the serosanguineous fluid, permits visualization of the nodular pleural densities, an important diagnostic feature. Pleural thickening and rapid recurrence of the pleural exudate, associated with fixation of the mediastinum, are other characteristic roentgen features. Angiocardiography aids the recognition of pericardial and cardiovascular involvement.

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

In plain English

This 1955 case series came from The New York Hospital-Cornell Medical Center. It described X-ray and other imaging findings in 12 patients with pleural mesothelioma, 5 localized and 7 diffuse. The article does not mention asbestos or any other cause or exposure. The authors wrote that none of the 5 localized cases (4 women and a man, aged 24 to 71) had a pleural effusion, though drainage in one yielded small amounts of fluid. Two of them looked localized on X-ray but proved malignant at surgery. One of these two died fifteen days after the operation, and the other's tumor came back. The other three localized patients were well 7 to 12 years after surgery. All 7 diffuse cases were men. Fluid from 6 patients in the series was tested for cancer cells, and 2 were positive. Five of the diffuse cases were reported to have died, and the other two were last described as near death or transferred for terminal care. The authors concluded that localized pleural mesothelioma is usually benign but may be an early stage of the diffuse type, which is always malignant.

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 series (12 case reports with discussion of X-ray features)
• Who was studied: 12 patients with pleural mesothelioma admitted between 1940 and 1953, from The New York Hospital-Cornell Medical Center, with Cases III and VI from Memorial Hospital. 5 had the localized type (4 women and a man, aged 24, 28, 40, 50 and 71) and 7 had the diffuse type (all men).
• Exposure: The article does not mention asbestos or any other exposure.
• Main results:
  • The authors reported that none of the 5 localized cases in their series had a pleural effusion.
  • In Case IV (localized), however, a thoracentesis yielded small amounts of thin yellow sterile fluid.
  • In Cases II and III, the disease appeared localized on X-ray but proved malignant at thoracotomy.
  • Case II (localized, malignant) died suddenly fifteen days after the operation.
  • Case III (localized, malignant) developed a large recurrent mediastinal tumor and lung metastases six months after surgery.
  • Case I (localized) was well with no evidence of disease twelve years after surgery.
  • Case IV (localized, benign) was well eight years later.
  • Case V (localized, benign) had no recurrence seven years after operation.
  • In Case III, angiocardiography revealed a pericardial effusion that had not been suspected.
  • Pleural fluid from 6 patients in the series was examined for cancer cells, and 2 were positive.
  • All 7 patients with diffuse pleural mesothelioma were men.
  • Among the 7 diffuse cases, five (Cases VII to XI) were reported to have died. Case VI was last seen appearing near death, and Case XII was transferred for terminal care. For example, Case IX died sixteen months after operation.
• The authors' conclusion: The authors concluded that localized pleural mesothelioma is usually benign but may prove to be an early stage of the diffuse malignant type, and that diffuse pleural mesothelioma is always malignant.

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: Roentgen, Pleural Mesothelioma, Pleura, Intrathoracic, Pericardial, Thoracotomy, Pleural Effusion, Pneumothorax.

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