The importance of retaining post mortem tissue--'pseudomesotheliomatous' Merkel cell carcinoma of the pleura

Our plain-English summary of The importance of retaining post mortem tissue--'pseudomesotheliomatous' Merkel cell carcinoma of the pleura, by G.D. Leopold, R.L. Attanoos (Histopathology, 2011).

The study

• Authors: G.D. Leopold, R.L. Attanoos
• Journal: Histopathology
• Published: 2011;58(7):1180-2
• Type of article: Case report, Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the journal was a case report about one patient. He was a 65-year-old man who had worked as an underground coal miner in South Wales for 30 years. The authors reported no definite history of asbestos exposure. In January 2007 he was diagnosed with Merkel cell carcinoma, a skin cancer, on his right thigh, and it was removed. In August 2008 he became severely breathless and had a large fluid collection around the heart. Fluid drained from it showed no cancer cells, and he died the same day. At post mortem, tumour completely encased the right lung and the sac around the heart and had invaded the ribs. Its spread and appearance resembled malignant mesothelioma. There was no primary lung tumour and no coal workers' pneumoconiosis. Tissue decay limited examination under the microscope. Special staining (immunohistochemistry) confirmed the tumour was Merkel cell carcinoma that had spread. The authors stated that there is no recognized link between Merkel cell carcinoma and asbestos exposure. They concluded that the case showed the practical need to retain post mortem tissue in specialist occupational cases.

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 (letter to the journal, Correspondence)
• Who was studied: one 65-year-old man who had been an underground coal miner in South Wales for 30 years
• Exposure: underground coal mining for 30 years; no definite history of asbestos exposure
• Main results:
  • The patient was diagnosed with a Merkel cell carcinoma of the skin of the right thigh in January 2007, which was excised
  • A pericardiocentesis (draining of fluid from around the heart) showed no cytological evidence of malignancy, and the patient died the same day
  • At post mortem, the right lung and pericardial sac were completely encased by tumour, with invasion of the ribs, and the tumour's distribution and appearance were reminiscent of malignant mesothelioma
  • There was no primary lung tumour and no evidence of coal workers' pneumoconiosis
  • Immunohistochemistry confirmed metastatic Merkel cell carcinoma. The tumour was strongly positive for Chromogranin A, CD 56, Synaptophysin and CK 20, and negative for Calretinin, CK5/6, TTF-1, CK7 and CD45
• The authors' conclusion: The authors stated that there is no recognized link between Merkel cell carcinoma and asbestos exposure. They believed the case illustrates the practical necessity of retaining post mortem tissue for histology in the specialist occupational setting.
• Limitations the authors state:
  • Marked autolysis (tissue decay) prevented accurate assessment of the tumour's appearance under the microscope

Topics

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

Medical terms in this study, explained in our Lexicon: Carcinoma, Pleura.

Related studies

• Extrapulmonary small cell carcinoma — H.F. van der Heijden, Y.F. Heijdra (2005)
• Pseudomesotheliomatous small-cell neuroendocrine carcinoma of the lung with calretinin expression — G.D. Exarchos, R.L. Attanoos (2015)
• 'Pseudomesotheliomatous' carcinomas of the pleura: a 10-year analysis of cases from the Environmental Lung Disease Research Group, Cardiff — R.L. Attanoos, A.R. Gibbs (2003)
• Acne inversa complicated by squamous cell carcinoma in association with diffuse malignant peritoneal mesothelioma arising in the absence of predisposing factors: a case report — V. Barresi, E. Vitarelli, et al. (2008)
• Initiation-promotion versus complete skin carcinogenesis in mice: importance of dark basal keratinocytes (stem cells) — T.J. Slaga, A.J. Klein-Szanto (1983)
• Pseudomesotheliomatous carcinoma involving pleura and peritoneum: A clinicopathologic and immunohistochemical study of three cases — I.A. Shah, J.R. Salvatore, et al. (1999)

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