Unexpected longevity of a patient with malignant pleural mesothelioma: report of a case

Our plain-English summary of Unexpected longevity of a patient with malignant pleural mesothelioma: report of a case, by A. Fischbein, Y. Suzuki, I.J. Selikoff, et al (Cancer, 1978).

The study

• Authors: A. Fischbein, Y. Suzuki, I.J. Selikoff, J.G. Bekesi
• Journal: Cancer
• Published: 1978;42(4):1999-2004
• Type of article: Case report
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001074).

Abstract

A 53-year-old male with untreated malignant pleural mesothelioma and with seven years survival time since the appearance of clinical symptoms is reported. Histopathological and immunological findings were at variance with those usually seen with mesothelioma. Both lymphocyte surface markers and lymphocyte function values were found to be within normal range; in contrast, in eleven mesothelioma patients who progressed and died, both numerical and functional defects in T and B lymphocytes were seen. There was potential for neighborhood asbestos exposure.

In plain English

This was a case report of a 53-year-old man with malignant pleural mesothelioma (epithelial form) who lived seven years after symptoms began without specific treatment. His breathlessness and right-sided chest pain began in January 1970; a 1972 pleural biopsy gave the diagnosis. A second biopsy in 1976 showed tumor growing into chest wall muscle, with myxomatous degeneration of the tumor's supporting tissue (stroma). Chest X-rays in May 1977 showed progression, but tests found no evidence of spread elsewhere. A review of his work history did not identify any direct asbestos exposure. He had, however, worked from 1957 to 1966 at a plant next to the Brooklyn Navy Yard, where much asbestos was used. The authors compared his blood lymphocyte tests with those of 28 healthy donors and 11 patients with advanced mesothelioma and a progressive downhill course. The 11 patients showed defects in T and B lymphocytes; this patient's results were within the normal range. The authors suggested that the tumor stroma and his lack of immune impairment may have contributed to his unusual course. They also said neighborhood asbestos exposure may have occurred.

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), with laboratory comparison against healthy donors and other mesothelioma patients
• Who was studied: One 53-year-old man in New York with malignant pleural mesothelioma. Symptoms began January 1970, diagnosis was in 1972, and he was followed to 1977. Comparison groups were 28 healthy donors and 11 patients with advanced malignant mesothelioma.
• Exposure: Review of his occupational history did not identify any direct asbestos exposure. He was employed at a plant adjacent to the Brooklyn Navy Yard from 1957 to 1966, where much asbestos was used. Fiber type was not stated.
• Main results:
  • The 1972 pleural biopsy was diagnosed as malignant pleural mesothelioma, epithelial form
  • The patient received no specific treatment for the disease
  • The second biopsy (June 1976) showed tumor cells infiltrating the striated muscle of the chest wall
  • The tumor stroma in the second biopsy showed myxomatous degeneration
  • May 1977 chest X-rays showed marked pleural thickening in the right lower lung field and scalloping of the pleura in the upper lung field
  • No evidence of metastatic disease was found
  • Review of the occupational history did not identify any direct asbestos exposure
  • Pulmonary function tests showed severe restrictive impairment, with FVC at 46% of predicted
  • The patient's immune tests were compared with those of 28 healthy donors and 11 patients with advanced malignant mesothelioma, each of whom had a progressive downhill course
  • In each of the 11 patients with advanced malignant mesothelioma there were numerical and functional defects in T and B lymphocytes, while the case patient's surface marker and function values were within the normal range
  • T-cells (E-rosettes) made up 75% in the case patient, against 73 in normal controls and 45.6 in the eleven mesothelioma patients (Table 1)
  • The patient showed a strong delayed skin hypersensitivity response to mumps, candida and varidase
  • No circulating serum blocking factor was found in the patient, unlike the 11 patients
• The authors' conclusion: The authors concluded that the tumor stroma's characteristics and the absence of significant immune impairment may have contributed to the patient's unusual course, and that neighborhood asbestos exposure may have occurred.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma, Asbestos Exposure.

Related studies

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• Proliferation stimulating effects of chrysotile and crocidolite asbestos fibres on B lymphocyte cell lines — A. Ueki, T. Oka, et al. (1984)
• Iron as a target of chemoprevention for longevity in humans — S. Toyokuni (2011)
• Unexpected complication of successful nerve block. Morphine induced respiratory depression precipitated by removal of severe pain — G.W. Hanks, R.G. Twycross, et al. (1981)
• Next-generation sequencing informs diagnosis and identifies unexpected therapeutic targets in lung squamous cell carcinomas — J.M. Sands, T. Nguyen, et al. (2020)
• Malignant Pleural Mesothelioma: Genetic and Microenviromental Heterogeneity as an Unexpected Reading Frame and Therapeutic Challenge — D.M. Abbott, C. Bortolotto, et al. (2020)

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