The value of 18F-FDG PET/CT in two cases of Primary Pericardial Mesothelioma

Our plain-English summary of The value of 18F-FDG PET/CT in two cases of Primary Pericardial Mesothelioma, by A. Utrera-Costero, J.C. Bernal-Vergara, P. Olivan-Sasot, et al (Journal of Nuclear Cardiology, 2022).

The study

• Authors: A. Utrera-Costero, J.C. Bernal-Vergara, P. Olivan-Sasot, A.M. Yepes-Agudelo, C. Ruiz-Llorca, V.J. Vera-Pinto, P. Bello-Arqués
• Journal: Journal of Nuclear Cardiology
• Published: 2022;29(6):3604-3607
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This short image-based report, from nuclear medicine departments in Valencia, Spain, described two patients diagnosed with primary pericardial mesothelioma, a cancer of the lining around the heart. It showed how their 18F-FDG PET/CT scans looked. The first patient was a 77-year-old woman who had breast cancer surgery 30 years earlier and was breathless from fluid around the heart. Her scan showed intense nodular uptake in the pericardium (SUVmax 9.21) and no other area suggesting a different primary tumor. A surgical biopsy diagnosed pericardial mesothelioma. The second patient was a 39-year-old man with a double-lung transplant for cystic fibrosis. Because he was immunosuppressed, lymphoma was first suspected. His scan showed pericardial thickening with a maximum uptake value of 9 and spread to thoracic lymph nodes, and biopsy diagnosed pericardial mesothelioma. The article did not report asbestos exposure for either patient. The authors noted that a link with asbestos is still controversial for pericardial mesothelioma. The authors concluded that, although diagnosis rests on tissue examination, PET/CT can guide a correct biopsy.

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: Two-patient case report ("Images that teach" format)
• Who was studied: Two patients at nuclear medicine departments in Valencia, Spain: a 77-year-old woman with prior breast cancer surgery, and a 39-year-old man with a double-lung transplant for cystic fibrosis. No dates of care are given.
• Exposure: No asbestos or other exposure is reported for either patient. The authors note, citing other literature, that the association of pericardial mesothelioma with asbestos is still controversial.
• Main results:
  • Case 1 (77-year-old woman): PET/CT showed multiple hypermetabolic foci corresponding to intense nodular pericardial uptake, SUVmax 9.21
  • Case 1: PET/CT did not identify another hypermetabolic area suggesting a different primary tumor
  • Case 1: surgical biopsy with immunochemistry led to a diagnosis of pericardial mesothelioma
  • Case 2 (39-year-old man): PET/CT showed hypermetabolic nodular thickening and calcifications of the pericardium, with a maximum standardized uptake value of 9
  • Case 2: there was invasion of thoracic lymph node stations, with no other hypermetabolic lesion
  • Case 2: because the patient was immunosuppressed, the initial diagnosis was secondary cardiac involvement of lymphoma; biopsy instead diagnosed pericardial mesothelioma
• The authors' conclusion: The authors concluded that, although the diagnosis is made by tissue examination, PET/CT can guide a correct biopsy and improve knowledge of this disease's imaging patterns.

Topics

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

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

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