Simultaneous bilateral spontaneous pneumothorax in a patient with peritoneal and pleural papillary mesothelioma

Our plain-English summary of Simultaneous bilateral spontaneous pneumothorax in a patient with peritoneal and pleural papillary mesothelioma, by P. Höllinger, D. Gaeng (Respiration; International Review of Thoracic Diseases, 1997).

The study

• Authors: P. Höllinger, D. Gaeng
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 1997;64(3):233-5
• Type of article: Case report
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Simultaneous bilateral spontaneous pneumothorax (SBSP) occurred in a patient with papillary mesothelioma of peritoneum and pleura. The patient initially suffered from ascites due to peritoneal tumor studding and later presented with simultaneous bilateral spontaneous pneumothorax. As the disease spread from the abdomen to the pleural cavity, a moderate loss of histologic differentiation was observed.

In plain English

This article is a case report about one patient, from hospitals in Olten and Aarau, Switzerland. A 77-year-old man was admitted in November 1991 with a steadily enlarging abdomen from fluid buildup (ascites). The fluid was negative for microbes and malignant cells. A laparoscopy, however, found small white nodules on the abdominal lining, diagnosed as well-differentiated papillary mesothelioma of the peritoneum (WDPMP). In March 1992 a symptomless collapsed right lung (pneumothorax) was found. A pleural biopsy then showed a well to moderately differentiated, partly papillary, partly solid mesothelioma. In July 1994 he returned with worsening breathlessness; a chest X-ray showed both lungs collapsed at once, the left completely and the right subtotally. Air was drawn off the left side, and talc pleurodesis was later done on both sides. He died in December 1994 of progressive wasting (cachexia); no autopsy was permitted. The authors described a moderate loss of tissue differentiation as the disease spread from abdomen to chest. They added that solid areas in the first biopsy may have been underestimated. The article does not mention asbestos exposure or work history.

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)
• Who was studied: One 77-year-old man treated at the Kantonsspital in Olten, Switzerland, followed from November 1991 until his death in December 1994
• Main results:
  • In November 1991, fluid drawn from the patient's abdomen was negative for microbes and malignant cells.
  • In November 1991, laparoscopy showed nodules on the abdominal lining. On examination of the tissue, these corresponded to well-differentiated papillary mesothelioma of the peritoneum (WDPMP).
  • In March 1992, an asymptomatic right-sided spontaneous pneumothorax was found. A pleural biopsy taken at the same time showed a well to moderately differentiated, partly papillary, partly solid mesothelioma.
  • In July 1994, the patient was readmitted with progressive shortness of breath. A chest X-ray showed bilateral pneumothorax with complete collapse of the left lung and subtotal collapse of the right lung.
  • After air was drawn off the left side by catheter, the left lung fully re-expanded and the shortness of breath was relieved.
  • After talc pleurodesis on both sides, the pleural biopsy showed the same tissue pattern as in 1992.
  • As the disease spread from the abdomen to the pleural cavity, a moderate loss of tissue differentiation was observed.
  • The patient died in December 1994 from progressive cachexia. Permission for an autopsy was not given.
• The authors' conclusion: The authors considered the case noteworthy for two reasons. First, simultaneous bilateral spontaneous pneumothorax is rare. Second, a tumor that began as WDPMP spread from the abdomen to the pleural cavity and showed dedifferentiation. The authors stated that such a change had been described in peritoneal papillary mesothelioma, but not in a tumor involving two body cavities.
• Limitations the authors state:
  • The authors noted that the few solid areas in the first peritoneal biopsy may have been underestimated, which could affect the apparent change in differentiation.

Topics

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

Medical terms in this study, explained in our Lexicon: Bilateral, Pneumothorax, Well-Differentiated Papillary Mesothelioma, Peritoneum, Pleura, Ascites, Pleural Cavity.

Related studies

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• Spontaneous pneumothorax and pulmonary malignant disease--a syndrome sometimes associated with cavitating tumours. Report of nine new cases, four with metastases and five with primary bronchial tumours — F.W. Wright (1976)
• Malignant pleural mesothelioma presenting as spontaneous pneumothorax: a case series and review — S. Alkhuja, A. Miller, et al. (2000)
• Pleural granuloma mimicking malignancy 42 years after slurry talc injection for primary spontaneous pneumothorax — S. Tenconi, L. Luzzi, et al. (2010)
• Malignant pleural mesothelioma detected by spontaneous pneumothorax — A. Makidono, M. Matsusako, et al. (2010)

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