Sarcomatoid pleural mesothelioma

Our plain-English summary of Sarcomatoid pleural mesothelioma, by S.P. Hammar, J.W. Bolen (Ultrastructural Pathology, 1985).

The study

• Authors: S.P. Hammar, J.W. Bolen
• Journal: Ultrastructural Pathology
• Published: 1985;9(3-4):337-43
• Type of article: Case report
• Cited by: 10 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. 000477).

In plain English

This was a case report from a Seattle pathology department about one patient, a 56-year-old man who had worked as an asbestos insulator most of his adult life. It did not say which type of asbestos fiber he was exposed to. After vague abdominal symptoms in 1981, a liver mass was found, removed and diagnosed as an undifferentiated neoplasm. In February 1984 he had right chest pain, a pleural effusion and a pleural mass, which was partly removed by surgery. He died in July 1984. At autopsy the tumor encased the right lower lung lobe and had invaded the diaphragm, mediastinum and pericardium. Under the light microscope it looked consistent with sarcomatoid mesothelioma. The tumor cells stained strongly for low molecular weight cytokeratin and for vimentin, but not for higher molecular weight cytokeratin. Electron microscopy showed no microvilli, and the cells lacked the extensive rough endoplasmic reticulum most fibroblasts have. Combining this case with earlier experimental studies and their own previous work, the authors proposed that sarcomatous and desmoplastic mesotheliomas arise from connective tissue cells beneath the mesothelium, which they called "multipotential subserosal cells."

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: clinical history, autopsy, light microscopy, immunohistochemistry and electron microscopy)
• Who was studied: one 56-year-old man; the authors were at a pathology department in Seattle, Washington; he died in July 1984
• Exposure: work as an asbestos insulator for most of his adult life; no fiber type or dose given for this patient
• Main results:
  • He developed vague abdominal symptoms in 1981; an isolated liver mass was found, resected and diagnosed as an undifferentiated neoplasm (the date of the resection is not given)
  • In February 1984 he had right chest pain and was found to have a pleural effusion and pleural mass; the mass was partially resected
  • The patient died in July 1984
  • At autopsy the tumor encased the right lower lobe, invaded the diaphragm, extended into the right colic gutter, invaded the mediastinum and penetrated the parietal pericardium
  • Light microscopy showed pleomorphic spindle- to polygonal-shaped cells; the tumor was negative for mucicarmine, PAS and Alcian blue stains, and its morphology was consistent with a sarcomatoid mesothelioma
  • Tumor cells stained strongly for low molecular weight cytokeratin and were negative for higher molecular weight cytokeratin
  • The same area of tumor that stained for cytokeratin also stained for vimentin
  • On electron microscopy the cells lacked the extensive rough endoplasmic reticulum of most fibroblasts, contained intermediate filaments, were joined by moderately formed intercellular junctions, and had no microvilli
• The authors' conclusion: Combining their observations with published experimental studies, the authors proposed that sarcomatous and desmoplastic mesotheliomas derive from a neoplastic proliferation of submesothelial connective tissue cells, which they termed multipotential subserosal cells

Topics

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

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

Related studies

• Lymphohistiocytoid mesothelioma. An often misdiagnosed variant of sarcomatoid malignant mesothelioma — H.S. Khalidi, L.J. Medeiros, et al. (2000)
• Immunohistochemical differentiation of sarcomatoid mesotheliomas from other spindle cell neoplasms — P.T. Cagle, L.D. Truong, et al. (1989)
• Sarcomatoid mesothelioma: a clinical-pathologic correlation of 326 cases — S. Klebe, N.A. Brownlee, et al. (2010)
• Pleomorphic epithelioid diffuse malignant pleural mesothelioma: a clinicopathological review and conceptual proposal to reclassify as biphasic or sarcomatoid mesothelioma — K. Kadota, K. Suzuki, et al. (2011)
• Diagnostic usefulness of p16/CDKN2A FISH in distinguishing between sarcomatoid mesothelioma and fibrous pleuritis — D. Wu, K. Hiroshima, et al. (2013)
• GATA3 Immunohistochemistry for Distinguishing Sarcomatoid and Desmoplastic Mesothelioma From Sarcomatoid Carcinoma of the Lung — K.B. Berg, A. Churg (2017)

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