Imaging, pathological and molecular detection of malignant peritoneal mesothelioma (MPM): a case description

Our plain-English summary of Imaging, pathological and molecular detection of malignant peritoneal mesothelioma (MPM): a case description, by X. Zhang, X. Li, R. Zhang, et al (Quantitative Imaging in Medicine and Surgery, 2024).

The study

• Authors: X. Zhang, X. Li, R. Zhang, H. Xu, J. Zhang, Y. Xiong, H. Zhao, L. Lin
• Journal: Quantitative Imaging in Medicine and Surgery
• Published: 2024;14(12):9813-9819
• Read it: PubMed · Publisher · Free full text

In plain English

This letter to the editor was a case report of one patient at Peking University First Hospital, Beijing, China. He was an 83-year-old man with 5 months of dry mouth and weight loss and 3 months of poor appetite. He had fever and high markers of inflammation in his blood. CT and PET-CT scans showed thickening of the peritoneum, the lining of the abdomen. Infection was suspected, but several antibiotics brought little improvement. Laparoscopy found fluid in the abdomen and multiple nodules on the peritoneum and omentum. Genetic sequencing (mNGS) of that fluid and of peritoneal tissue showed chromosome changes that suggested a tumor. Sequencing of his blood found bacteria, mainly Pseudomonas aeruginosa. Tissue testing led to a diagnosis of epithelioid malignant mesothelioma. Chemotherapy was judged unsuitable because of his poor physical condition, and his family chose supportive care. The article did not report whether he had any asbestos exposure. The authors described this as the first case of malignant peritoneal mesothelioma diagnosed with the help of mNGS. They concluded that mNGS is useful for identifying pathogens and as an aid in diagnosing cancers.

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 (published as a letter to the editor)
• Who was studied: One 83-year-old male patient admitted to Peking University First Hospital, Beijing, China, with dry mouth and emaciation for 5 months and anorexia for 3 months
• Exposure: The article does not report any asbestos or other occupational or environmental exposure history for this patient
• Main results:
  • After admission the patient had fever and raised inflammatory markers, including CRP 136.51 mg/L and ESR 121 mm/h
  • PET-CT showed peritoneal thickening and high glucose metabolism in the mesentery, omentum and part of the colon wall
  • Infection was suspected, but symptoms and inflammatory markers improved poorly with several antibiotics
  • Laparoscopy showed ascites and multiple nodules on the peritoneum and omentum
  • mNGS of blood detected Gram-negative bacteria, mainly Pseudomonas aeruginosa, which were not found in the other specimens
  • Copy number analysis by mNGS of ascitic fluid and peritoneal tissue showed significant alterations in chromosomes 7, 11, 16 and 17, suggesting a tumor
  • Pathology and immunohistochemistry (cells strongly positive for markers including calretinin and CK5/6; Ki67 index about 30%) led to an initial diagnosis of epithelioid malignant mesothelioma
  • Chemotherapy was judged unsuitable because of the patient's poor physical condition, and the family chose supportive treatment
• The authors' conclusion: The authors concluded that mNGS is useful for identifying pathogens and, through copy number variation analysis, as an aid in diagnosing cancers. They described this as the first case of MPM diagnosed with the help of mNGS.

Topics

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

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