Timely diagnosis of primary pericardial mesothelioma

Our plain-English summary of Timely diagnosis of primary pericardial mesothelioma, by H.C. Chen, S. Chang, M.C. Hsiung, et al (Echocardiography, 2020).

The study

• Authors: H.C. Chen, S. Chang, M.C. Hsiung, W.K. Kwang, T.P. Tsao, Y.N. Yang
• Journal: Echocardiography
• Published: 2020;37(11):1877-1879
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a brief case report, published as an image article, by authors at Cheng Hsin General Hospital in Taipei, Taiwan. It described one 66-year-old man with shortness of breath and swelling of both lower legs. He was a nonsmoker and denied any prior asbestos exposure. A heart ultrasound (echocardiogram) showed an irregular, thickened sac around the heart (the pericardium) and a large amount of fluid around the heart. Fluid drained from the sac was suspected to be malignant on cytology testing, and a surgical biopsy of the pericardium was reported as malignant mesothelioma. Under the microscope, the tumor was made of epithelioid cells, stained positive for calretinin, and showed loss of the BAP1 protein. A PET scan showed increased uptake across the whole pericardium and in multiple lymph nodes in the front of the chest. The patient received chemotherapy and died after two months. Citing earlier studies, the authors wrote that the link between asbestos and primary pericardial mesothelioma remains controversial. They concluded that echocardiography, followed by cytology and biopsy, led to a timely diagnosis in this case.

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 (image article) of a single patient
• Who was studied: one 66-year-old man, a nonsmoker, with shortness of breath and swelling of both lower legs; the authors are from Cheng Hsin General Hospital, Taipei, Taiwan
• Exposure: The patient denied any prior asbestos exposure; no fiber type or job exposure was reported
• Main results:
  • Echocardiography in this patient showed an irregular, thickened pericardium with heterogeneous infiltration and a large pericardial effusion
  • Cytology of fluid drained from the pericardium was suspected to be malignant
  • Pericardiotomy and biopsy were reported as malignant mesothelioma
  • The tumor was composed of epithelioid cells in a solid pattern and was immuno-reactive for calretinin; staining also showed loss of BAP1
  • PET showed increased FDG uptake at the pericardium of the whole heart and multiple hypermetabolic lymph nodes in the anterior mediastinum
  • After drainage, echocardiography suggested constrictive physiology, with a deceleration time below 160 ms
  • The patient underwent chemotherapy and died after two months
• The authors' conclusion: The authors concluded that detection of the infiltrated pericardium on echocardiography, followed by cytology that suggested malignancy and then pericardiotomy and biopsy, led to a timely diagnosis in this case

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.

Related studies

• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Primary pericardial tumors — C.S. Restrepo, D. Vargas, et al. (2013)
• Primary pericardial mesothelioma: report of two cases and review of the literature — A.L. Sytman, R.N. MacAlpin (1971)
• Primary pericardial mesothelioma — N.T. Eren, A.R. Akar (2002)
• Treatment and Outcomes of Primary Pericardial Mesothelioma: A Contemporary Review of 103 Published Cases — E. McGehee, D.E. Gerber, et al. (2019)
• Primary pericardial mesothelioma following exposure to asbestos — E.I. Kahn, A. Rohl, et al. (1980)

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