Roentgenogram of the month

Our plain-English summary of Roentgenogram of the month, by C.L. Adams (Diseases of the Chest, 1965).

The study

• Author: C.L. Adams
• Journal: Diseases of the Chest
• Published: 1965;48(4):427-8
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This article was a single case report in the journal's "Roentgenogram of the Month" chest X-ray feature, by an author based in Lansing, Michigan. It described a 63-year-old man admitted with nine months of severe shortness of breath, cough, left chest pain, vague abdominal discomfort and a weight loss of 46 pounds. Watery red fluid kept building up around his left lung and needed draining every two weeks. The only positive diagnostic finding came from a needle pleural biopsy: undifferentiated carcinoma in skeletal muscle. His admission X-ray showed air and fluid in the left chest, with many nodules on the chest-wall lining that were no longer visible after the lung was re-expanded. At autopsy, malignant diffuse mesothelioma covered the entire left pleura and had spread to both lungs. The article did not say whether this patient was exposed to asbestos. The author wrote that the cause was unknown but that a link with asbestos exposure had been reported. The author concluded that, short of surgery, diagnostic pneumothorax (air in the chest) is the only relatively harmless way to reveal such tumors.

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, chest X-ray teaching feature)
• Who was studied: One 63-year-old man. The author was based in Lansing, Michigan. The hospital and dates were not stated.
• Exposure: No asbestos or other exposure was reported for this patient. The author noted only, in general terms, that the cause of mesothelioma was unknown but that a correlation with asbestos exposure had been reported.
• Main results:
  • The patient had severe shortness of breath for nine months, a productive cough, left chest pain, abdominal discomfort and a weight loss of 46 pounds.
  • Large volumes of watery red fluid reaccumulated rapidly, and drainage (thoracentesis) was needed every two weeks.
  • The only positive diagnostic information came from a needle pleural biopsy, which showed undifferentiated carcinoma in skeletal muscle.
  • The admission X-ray showed a left hydropneumothorax with extensive nodules on the parietal pleura. These nodules were not visible after the lung was expanded.
  • At autopsy, malignant diffuse mesothelioma covered the left pleura entirely. Spread to both lungs (bilateral lymphangitic pulmonary metastases) explained the small opacities seen in the lung fields.
  • The only X-ray that revealed the pleural tumor was the one showing the spontaneous pneumothorax.
• The authors' conclusion: The author concluded that primary and secondary pleural tumors should be considered when pleural fluid keeps recurring. Short of exploratory surgery, diagnostic pneumothorax is the only relatively harmless method to reveal these tumors.

Topics

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

Related studies

• Roentgenogram of the month. Migrating lung tumor — R.H. Hayward (1974)
• Effect of tobacco smoking on the presence of asbestosis at postmortem and on the reading of irregular opacities on roentgenograms in asbestos-exposed workers — E. Hnizdo, G.K. Sluis-Cremer (1988)
• The detection of thoracic abnormalities using posterior-anterior (PA) vs PA and oblique roentgenograms — R.B. Reger, R.G. Ames, et al. (1982)
• Effect of tobacco smoking on the presence of asbestosis at postmortem and on the reading of irregular opacities on roentgenograms in asbestos-exposed workers — A. Kraut, J. Godbold, et al. (1989)
• 'It's all bad news': the first 3 months following a diagnosis of malignant pleural mesothelioma — A. Arber, L. Spencer (2013)
• Predictors of mortality within three months in the patients with malignant pleural effusion — M.O. Ozyurtkan, A.E. Balci, et al. (2010)

Browse more research in Diseases of the Chest, or return to medical research.