EUS in the intensive care unit in a patient with a history of mesothelioma

Our plain-English summary of EUS in the intensive care unit in a patient with a history of mesothelioma, by S. Carrara, E. Bottoni, G.M. Ferraroli, et al (Gastrointestinal Endoscopy, 2020).

The study

• Authors: S. Carrara, E. Bottoni, G.M. Ferraroli, L. Di Tommaso, A. Repici
• Journal: Gastrointestinal Endoscopy
• Published: 2020;92(1):214-215
• Read it: PubMed · Publisher

In plain English

This was a short case report about one patient. A 54-year-old woman had acute respiratory failure followed by cardiopulmonary arrest. She was resuscitated and admitted to the intensive care unit. One year earlier she had undergone a pleuro-pneumonectomy for mesothelioma. A CT scan suggested no recurrence, but given her history the doctors strongly suspected the mesothelioma had returned. They performed endoscopic ultrasound (EUS) at the bedside in the intensive care unit. It showed a thickened area between the diaphragm and the esophagus, and lymph nodes at station 9 and at the celiac trunk. Biopsies of the thickened area and of a celiac lymph node, taken with 25-gauge fork-tip needles, both showed recurrent mesothelioma. Treatment decisions were based on the poor prognosis. The authors concluded that the case confirms the role of EUS in examining the mediastinum, even when deciding care for a critically ill patient in intensive care. They also concluded it highlights the accuracy and safety of EUS needle biopsy in relapsed mesothelioma. The report does not mention asbestos or any other exposure.

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)
• Who was studied: One 54-year-old woman in an intensive care unit, after cardiopulmonary arrest, who had had a pleuro-pneumonectomy for mesothelioma one year earlier; the authors are at Humanitas Clinical and Research Center, Rozzano, Milan, Italy
• Exposure: Not reported; the article does not mention asbestos or any exposure
• Main results:
  • A CT scan suggested no recurrence of the mesothelioma
  • EUS showed a hypoechoic thickened area between the thoracic surface of the diaphragm and the esophagus
  • EUS detected lymph nodes at station 9 and at the celiac trunk
  • Biopsies of the diaphragmatic thickening (through the esophagus) and of the celiac lymph node (through the stomach) were taken with 25-gauge fork-tip needles; pathology showed recurrent mesothelioma in both
  • Treatment decisions were based on the patient's poor prognosis
• The authors' conclusion: The authors concluded that the case confirms the role of EUS in studying the mediastinum, even in decision-making for a critically ill patient in the intensive care unit. They also concluded it highlights the accuracy and safety of EUS fine-needle biopsy sampling in relapsed mesothelioma.

Topics

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

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

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