Recurrent Pericardial and Pleural Effusion due to Pericardial Pleomorphic Mesothelioma

Our plain-English summary of Recurrent Pericardial and Pleural Effusion due to Pericardial Pleomorphic Mesothelioma, by B. Segura-Méndez, Á. Fuentes-Martín, M. Loucel, et al (Korean Circulation Journal, 2022).

The study

• Authors: B. Segura-Méndez, Á. Fuentes-Martín, M. Loucel, J. Soro-García, Á. Cilleruelo
• Journal: Korean Circulation Journal
• Published: 2022;52(6):481-482
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

In plain English

This was a brief case report from a hospital in Valladolid, Spain. It described a 73-year-old woman with high blood pressure and diabetes who was admitted with chest pain, nausea and a left pulmonary embolism. Heart ultrasound showed severe fluid around the heart (pericardial effusion), which was drained. Fluid around both lungs (pleural effusion) was drained with chest tubes, and she improved. After 96 hours both effusions came back. A CT scan showed a thickened, nodular pericardium that looked malignant. Surgeons took a biopsy and made a drainage window using keyhole chest surgery (videothoracoscopy), but she died after the operation from multiorgan failure. Tissue examination showed a primary pericardial pleomorphic mesothelioma that had invaded the heart muscle and spread through lymphatic channels. Cytology was negative; the article did not say which sample was tested. The article did not report any asbestos exposure for this patient. It mentioned asbestos, radiation and tuberculosis only as general associations of this tumor. The authors stated that non-invasive tests are not effective for diagnosing it, and that diagnosis requires immunohistochemical study of the lesion.

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, published as an image article)
• Who was studied: one 73-year-old woman with arterial hypertension and diabetes, treated at the Clinic University Hospital of Valladolid, Spain
• Exposure: No asbestos or other exposure history was reported for this patient. The article names asbestos, radiation and tuberculosis only as general associations of pericardial pleomorphic mesothelioma.
• Main results:
  • The patient had severe pericardial effusion treated by pericardiocentesis. Bilateral pleural effusion was treated with drainage tubes, followed by clinical improvement.
  • Pericardial and bilateral pleural effusions recurred after 96 hours.
  • CT showed a nodular, thickened pericardium with a malignant appearance.
  • After videothoracoscopic biopsy and a pleuro-pericardial window, the patient died of refractory multiorgan failure in the postoperative period.
  • Pathology showed a primary pericardial pleomorphic mesothelioma.
  • The tumor had invaded the heart muscle (myocardium) and spread through lymphatic channels.
  • The autopsy showed pericardial and myocardial invasion.
  • Cytology was negative. The specimen tested is not stated.
• The authors' conclusion: The authors stated that non-invasive techniques are not effective in diagnosing pericardial mesothelioma, which requires immunohistochemical study of the lesion. They added that videothoracoscopy allows direct biopsy of the lesion.

Topics

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

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