Pleural mesothelioma and venous thrombosis: the eosinophilia link

Our plain-English summary of Pleural mesothelioma and venous thrombosis: the eosinophilia link, by P.R. Ames, W.W. Aye (Thrombosis Journal, 2008).

The study

• Authors: P.R. Ames, W.W. Aye
• Journal: Thrombosis Journal
• Published: 2008;6:3
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Peripheral blood eosinophilia and vascular occlusions are rare occurrences in patients with pleural mesothelioma whereas eosinophilia may associate with thrombosis. We describe a patient with mesothelioma who developed peripheral blood eosinophilia followed by deep vein thrombosis despite being on low molecular weight heparin prophylaxis. We discuss the genesis of peripheral blood eosinophilia and thrombosis in pleural mesothelioma.

In plain English

This article, by two authors at a UK hospital, is a case report of one patient. A 75-year-old man was admitted in early September 2007 with severe shortness of breath. A right pleural biopsy in mid-August 2007 had shown epithelioid mesothelioma. About a month earlier his blood eosinophils (a type of white blood cell) were raised at 1.6 × 10⁹ per litre. On admission they had risen to 21 × 10⁹ per litre. He was given a preventive dose of the blood thinner tinzaparin (3500 IU per day). On the fourth day an ultrasound confirmed a fresh clot in the popliteal vein of the leg. Tests for inherited clotting disorders were normal, and a genetic abnormality linked to one eosinophil disorder was not found. He died of respiratory failure. At post-mortem the mesothelioma surrounded and invaded the left lung and pericardium. No asbestos bodies and no pulmonary embolism were found. The authors concluded that the raised eosinophils, which they considered a reaction to the tumour, contributed to the clot more than the tumour itself. A single case shows what happened to one person, not how often it occurs.

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 75-year-old man admitted to an oncology/haematology ward in early September 2007; the authors were at the Department of Haematology, West Suffolk Hospital, UK
• Exposure: No asbestos exposure history is reported. The article does not name any fiber type, product or job. No asbestos bodies were found at post-mortem.
• Main results:
  • A right pleural biopsy in mid-August 2007 led to a diagnosis of epithelioid mesothelioma
  • The patient's blood eosinophils were 1.6 × 10⁹ per litre about a month before admission. During the admission they had risen to 21 × 10⁹ per litre, with CRP at 88 mg/dl and fibrinogen at 880 mg/dl.
  • The patient was started on prophylactic tinzaparin (3500 IU per day). On the fourth day after admission, ultrasound confirmed a fresh popliteal vein thrombosis.
  • The patient's thrombophilia screen was normal
  • Neither the FIP1L1-PDGFRA fusion transcript nor other cytogenetic abnormalities were found. The authors said this favoured a reactive eosinophilia in this patient.
  • The patient became confused with increasing hypoxia and died of respiratory failure
  • At post-mortem, mesothelioma had diffusely surrounded and invaded the left lung and pericardium without directly affecting blood vessels. No asbestos bodies and no pulmonary embolism were found.
• The authors' conclusion: The authors concluded that in this patient with pleural mesothelioma, reactive peripheral blood eosinophilia contributed to the development of deep vein thrombosis more than the tumour itself. They described this as occurring on a background of an inflammatory and eventually hypercoagulable state.

Topics

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

Related studies

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• Commentary: Focused attention on proactive identification of deep venous thrombosis after pleurectomy/decortication for malignant pleural mesothelioma — S.S. Groth, R.T. Ripley, et al. (2020)
• Diagnostic utility of pleural fluid eosinophilia — M. Adelman, S.M. Albelda, et al. (1984)
• Role of oxidants in interstitial lung diseases: pneumoconioses, constrictive bronchiolitis, and chronic tropical pulmonary eosinophilia — W.N. Rom (2011)
• Effectiveness of Nivolumab on Sarcomatoid Malignant Pleural Mesothelioma With Eosinophilia and Eosinophilic Pleural Effusion — M. Yamazoe, H. Ozasa, et al. (2019)
• Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma — L.E. De León, C.E. Bravo-Iñiguez, et al. (2020)

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