Small intestinal intussusception in an adult

Our plain-English summary of Small intestinal intussusception in an adult, by K. Takada, N. Fujimoto, T. Ozeki, et al (Journal of Clinical Pathology, 2019).

The study

• Authors: K. Takada, N. Fujimoto, T. Ozeki, J. Nishimura, Y. Miyamoto, M. Asano, Y. Fuchimoto, S. Wada, S. Ozaki, T. Igawa, H. Sonobe, T. Kishimoto
• Journal: Journal of Clinical Pathology
• Published: 2019;72(7):510
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This article was a case report about one 74-year-old man with a history of occupational asbestos exposure in a shipyard. He had been diagnosed with lymphohistiocytoid mesothelioma (LHM). After six courses of cisplatin and pemetrexed chemotherapy, his tumours shrank. Six months later the pleural tumours (on the lining around the lungs) grew again and partly invaded the liver. Further chemotherapy, including irinotecan and vinorelbine, was given, and his disease was stable for several months. The patient then had vomiting and abdominal pain. A CT scan showed intussusception, where part of the small intestine folds into itself. Surgeons removed part of the intestine and found a tumour, diagnosed as sarcomatous malignant pleural mesothelioma that had spread there. He died 2 months after the surgery, from progression of the mesothelioma. Autopsy found tumours on the pleura, peritoneum and pericardium and spread to many organs. The authors noted that it is debated whether LHM is an epithelioid or a sarcomatous type. They concluded that this case suggests LHM is similar to the sarcomatous subtype. The article did not name an asbestos fiber 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 of a single patient, presented as a 'Virtual case of the month' quiz; a follow-up of a case the authors had reported earlier
• Who was studied: one 74-year-old man diagnosed with lymphohistiocytoid mesothelioma, treated by the authors at Okayama Rosai Hospital, Japan
• Exposure: occupational asbestos exposure in a shipyard; fiber type and amount not stated
• Main results:
  • After six courses of cisplatin and pemetrexed chemotherapy, the patient's multiple tumours regressed
  • Six months after chemotherapy, the pleural tumours grew again and partly invaded the liver
  • Salvage chemotherapies, including irinotecan and vinorelbine, were given, and the disease was stable for several months. The article does not say the treatment caused the stability.
  • After sudden vomiting and abdominal pain, part of the small intestine was removed and a tumour was found in it
  • The intestinal tumour showed spindle-shaped cells with few lymphocytes. It stained positive for calretinin, CAM5.2, WT-1 and AE1/3 and negative for CK20, CD34 and desmin.
  • The intestinal tumour was diagnosed as a metastasis of malignant pleural mesothelioma, sarcomatous subtype (the quiz answer)
  • The patient died 2 months after the surgery due to progression of malignant pleural mesothelioma
  • Autopsy found multiple tumours on the pleura, peritoneum and pericardium, with metastasis to both lungs, liver, stomach, colon, rectum, thyroid, left kidney, spleen and lumbar spine. These tumours looked similar to the intestinal tumour.
• The authors' conclusion: The authors stated that it is still debated whether LHM is an epithelioid or sarcomatous subtype of malignant pleural mesothelioma. They concluded that this case suggests it is similar to the sarcomatous subtype.

Topics

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

Related studies

• Extrapulmonary small cell carcinoma mimicking malignant pleural mesothelioma — K. Noguchi, N. Fujimoto, et al. (2013)
• Malignant peritoneal mesothelioma giving rise to multiple intestinal polyps — F.G. Mayall, A.R. Gibbs (1991)
• Prognostic significance of the lymphocyte-to-monocyte ratio in patients with malignant pleural mesothelioma — T. Yamagishi, N. Fujimoto, et al. (2015)
• Brain metastases in malignant pleural mesothelioma — T. Yamagishi, N. Fujimoto, et al. (2016)
• Lymphoproliferative disorder in pleural effusion in a subject with past asbestos exposure — N. Hara, N. Fujimoto, et al. (2015)
• Diffuse malignant peritoneal mesothelioma presenting as intestinal obstruction — J. Griniatsos, S. Sougioultzis, et al. (2009)

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