Primary Mesothelioma Of The Pericardium

Our plain-English summary of Primary Mesothelioma Of The Pericardium, by W.J. Reals, B.C. Russum, E.M. Walsh (1947).

The study

• Authors: W.J. Reals, B.C. Russum, E.M. Walsh
• Published: Archives Of Pathology 44:380-384, October (1947)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 003227. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was a case report of one patient with a tumor the authors diagnosed as primary mesothelioma of the pericardium, the sac around the heart. The patient, a 38-year-old white farmer, was admitted to Creighton Memorial St Joseph's Hospital in May 1946 after six weeks of severe cough, chest fullness and chest pain on exertion, and had coughed up blood. Doctors first suspected fluid around the lung following pneumonia. On the third day in hospital the patient suddenly became short of breath and died within twenty minutes. At autopsy the pericardial sac held 1,000 cc of bloody fluid, and tumor masses covered the heart and invaded the heart muscle. The tumor had spread to the right lung area and right pleura, with deposits in the left lung and both kidneys. No other primary tumor was found, although the skull was not examined. The authors described the tumor as very rare, adding this case to 22 they found recorded in the literature. The article does not mention asbestos.

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 of a single patient (clinical history and autopsy), with a brief review of the earlier literature
• Who was studied: One 38-year-old white farmer admitted to Creighton Memorial St Joseph's Hospital on May 27, 1946
• Exposure: The article does not describe any asbestos or other exposure. The patient's occupation is given only as farmer.
• Main results:
  • The patient had six weeks of severe cough, fullness of the chest and chest pain on exertion before admission.
  • During the two weeks before admission the patient had coughed up small amounts of bright red blood on several occasions.
  • The initial (provisional) diagnosis was fluid around the lung following pneumonia.
  • On the third day after admission the patient suddenly became short of breath and died within twenty minutes.
  • At autopsy the pericardial sac contained 1,000 cc of bloody fluid.
  • Tumor masses almost completely covered the surface of the right ventricle and invaded the heart muscle for 0.3 cm.
  • No tumor was found within the bronchi.
  • The authors found no evidence that the pericardial tumor had spread from a cancer elsewhere.
  • The tumor had spread by all routes: deposits in the left lung and both kidneys, direct invasion of the right hilar area and lung, and lymphatic spread to the right pleura.
  • The anatomic diagnosis was primary mesothelioma of the pericardium.
  • The authors' review of the literature found 22 previously recorded cases of pericardial mesothelioma.
• The authors' conclusion: The authors concluded that mesothelioma of the pericardium is a very rare tumor, and that it can be diagnosed only after all other possible primary sites have been excluded.
• Limitations the authors state:
  • The authors report that relatives denied permission to examine the cranium, so the skull was not examined at autopsy.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pericardium, Autopsy, Pericardial, Pleura.

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