A rare case of mesothelioma showing micropapillary and small cell differentiation with aggressive behavior

Our plain-English summary of A rare case of mesothelioma showing micropapillary and small cell differentiation with aggressive behavior, by Y.J. Cha, B. Kim, J. Han, et al (Korean Journal of Pathology, 2014).

The study

• Authors: Y.J. Cha, B. Kim, J. Han, C.A. Yi, J.I. Zo
• Journal: Korean Journal of Pathology
• Published: 2014;48(6):466-8
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This brief case report, by pathologists, a radiologist and a thoracic surgeon at Samsung Medical Center in Seoul, Korea, described one patient: a 59-year-old woman with pleural mesothelioma. She had a two-month history of chest pain and, according to the article, no history of occupational or environmental asbestos exposure. A CT scan showed band-like thickening along the right pleura. Thoracoscopic surgery led to a diagnosis of malignant mesothelioma, epithelioid type. Despite chemotherapy given before surgery, the thickening progressed, and she underwent right extrapleural pneumonectomy. Under the microscope the tumor had two unusual cell populations. One was a micropapillary component resembling micropapillary adenocarcinoma of the lung. The other was a small cell component resembling small cell carcinoma of the lung. Tumor cells invaded lymphatic spaces and had spread to 35 lymph nodes. Electron microscopy and staining results supported mesothelioma. The authors concluded these features were definitive for mesothelioma. As a single case, it does not show how often such tumors occur, and the article reports no outcome after surgery.

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 (brief case report of a single patient)
• Who was studied: One 59-year-old woman with right pleural mesothelioma. The authors are at Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Dates of treatment are not given; the article was received in July 2014.
• Exposure: The patient had no history of occupational or environmental exposure to asbestos. No fiber type or product is named.
• Main results:
  • In this patient, right pleural and fissural thickening progressed on CT despite neoadjuvant chemotherapy, and she then underwent right extrapleural pneumonectomy.
  • In this patient's tumor, the micropapillary component at the invasive fronts had no fibrovascular core and resembled micropapillary adenocarcinoma of the lung.
  • In this patient's tumor, a small cell component resembled small cell carcinoma of the lung, with a high nuclear-cytoplasmic ratio.
  • In this patient, tumor cells frequently invaded lymphatic spaces and had spread to 35 lymph nodes.
  • Electron microscopy of this patient's tumor showed long, slender microvilli on the cell surface, which supported the diagnosis of mesothelioma.
  • In this patient's tumor, staining for TTF-1 was entirely negative, while D2-40 and HBME-1 outlined the tumor cell membranes.
  • In this patient's tumor, calretinin staining was weak and patchy in the micropapillary component, and only a few cells were positive in the small cell component.
• The authors' conclusion: The authors concluded that the clinical, radiological, microscopic and ultrastructural features, together with D2-40, HBME-1 and WT-1 expression, were definitive for a diagnosis of mesothelioma. They described the tumor as having uncommon micropapillary and small cell growth patterns with aggressive behavior.

Topics

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

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