Mixed micropapillary patterns found in malignant pleural mesothelioma with possibly worsened prognostic implication

Our plain-English summary of Mixed micropapillary patterns found in malignant pleural mesothelioma with possibly worsened prognostic implication, by T. Oyama, T. Goto, K. Amemiya (Thoracic Cancer, 2022).

The study

• Authors: T. Oyama, T. Goto, K. Amemiya
• Journal: Thoracic Cancer
• Published: 2022;13(7):1098-1099
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This was a short case image report from a hospital in Japan about one patient. A 60-year-old man had shortness of breath caused by fluid and thickening in the lining of the right lung. A surgical biopsy showed epithelioid mesothelioma. After three courses of chemotherapy he had an extrapleural pneumonectomy. The removed tissue was diagnosed as diffuse malignant epithelioid mesothelioma of the right pleura, with spread to a subcarinal lymph node in the center of the chest. Most of the tumor had a tubulopapillary structure. A micropapillary pattern made up 1%–5% of both the main tumor and the affected lymph nodes, and was also seen in nearby lymph vessels. The authors suggested this pattern may be linked to spread through the lymph system. Seven months after surgery he was receiving chemotherapy because the cancer had returned in chest lymph nodes. The report did not mention asbestos or any other exposure. Citing studies of other cancers, the authors proposed that a micropapillary pattern might signal a worse outlook in mesothelioma, but said this needs study in a larger group of patients.

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 (case image)
• Who was studied: One 60-year-old man with right pleural effusion and pleural thickening, reported by authors at Yamanashi Central Hospital, Japan
• Main results:
  • After three courses of chemotherapy, the patient underwent extrapleural pneumonectomy
  • Pathological diagnosis was diffuse malignant epithelioid mesothelioma of the right pleura
  • Most of the tumor had a tubulopapillary structure
  • Lymph node metastasis was found in a subcarinal lesion
  • A micropapillary pattern was a minor component, 1%–5% of the total lesion, in both the primary tumor and the metastatic lymph nodes
  • A micropapillary pattern was also seen in lymphatic vessels next to the metastatic lymph nodes; the authors suggested it may be associated with lymphatic spread of the tumor
  • The edges of the small micropapillary clusters stained positive for MUC1
  • Tumor cells were positive for CK5/6, D2-40 and calretinin, and negative for Wilm's tumor-1, thyroid transcription factor-1, napsin and carcinoembryonic antigen
  • Seven months after surgery, the patient was being treated with chemotherapy for recurrence in mediastinal lymph nodes
• The authors' conclusion: The authors concluded that their findings may become clinically useful pathological findings as further factors for a worse prognosis in mesothelioma. They based the link to aggressiveness on other studies reporting the micropapillary pattern as a predictor of aggressive carcinoma in various cancers.
• Limitations the authors state:
  • The authors stated that the prognostic role of the micropapillary pattern needs to be clarified in a larger cohort of patients with similar mesothelioma, including the sarcomatoid subtype

Topics

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

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

Related studies

• Clinicopathologic features and prognostic significance of lung tumours with mixed histologic patterns — E. Cakir, E. Demirag, et al. (2009)
• MicroRNA signature of malignant mesothelioma with potential diagnostic and prognostic implications — S. Busacca, S. Germano, et al. (2010)
• Prognostic Implications of the Complement Protein C1q in Gliomas — A. Mangogna, B. Belmonte, et al. (2019)
• Prognostic and Therapeutic Implications of MicroRNA in Malignant Pleural Mesothelioma — A. Truini, S. Coco, et al. (2016)
• Osteopontin, GLUT1 and Ki-67 expression in malignant peritoneal mesothelioma: prognostic implications — Y. Liu, G. Zheng, et al. (2021)
• Fiber burden and patterns of asbestos-related disease in workers with heavy mixed amosite and chrysotile exposure — A. Churg, S. Vedal (1994)

Browse more research in Thoracic Cancer, or return to medical research.