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Current Problems in Cardiology Dec 2022Diffuse primary malignant pericardial mesothelioma (PMPM) is an extremely rare and highly invasive tumor of pericardium. The tumor can infiltrate myocardium in part of... (Review)
Review
Diffuse primary malignant pericardial mesothelioma (PMPM) is an extremely rare and highly invasive tumor of pericardium. The tumor can infiltrate myocardium in part of cases, and will contribute to grave prognosis. Herein, we reported a 58-year-old man of diffuse PMPM with myocardial involvement, and summarized 39 cases of diffuse PMPM. Multimodal echocardiography, which combined conventional, tissue Doppler and speckle tracking echocardiography, was applied to diagnose diffuse PMPM with myocardial involvement, and assess the myocardial function. The common features were pericardial effusion, pericardial masses and thickened pericardium. The other echocardiographic characteristics were extensive and heterogenous echo, adhesion with pericardium and myocardium, reduced motion of adhered myocardium, and constriction performance. Diffuse PMPM with myocardial involvement revealed decreased LV diastolic function, and decreased LV and RV systolic function. Especially in systolic function, the unique strain features were reduced longitudinal strains from segmental to global and from epicardial to endocardial, relative 'septal sparing' pattern, and decreased transmural gradient of longitudinal strain. Our findings suggested that multimodal echocardiography not only can identify this disease, but also can provide detailed information of myocardial dysfunction, which provides a reference for clinicians to develop an optimal individualized treatment.
Topics: Humans; Middle Aged; Echocardiography; Myocardium; Pericardium; Pericardial Effusion; Mesothelioma
PubMed: 36007620
DOI: 10.1016/j.cpcardiol.2022.101356 -
Advances in Anatomic Pathology Jul 2023Malignant mesothelioma is a rare tumor arising from the mesothelial cells that line the pleura, pericardium, peritoneum, and tunica vaginalis. Imaging plays a primary...
Malignant mesothelioma is a rare tumor arising from the mesothelial cells that line the pleura, pericardium, peritoneum, and tunica vaginalis. Imaging plays a primary role in the diagnosis, staging, and management of malignant mesothelioma. Multimodality imaging, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), and F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), is used in a variety of scenarios, including diagnosis, guidance for tissue sampling, staging, and reassessment of disease after therapy. CT is the primary imaging modality used in staging. MRI has superior contrast resolution compared with CT and can add value in terms of determining surgical resectability in equivocal cases. MRI can further assess the degree of local invasion, particularly into the mediastinum, chest wall, and diaphragm, for malignant pleural and pericardial mesotheliomas. FDG PET/CT plays a role in the diagnosis and staging of malignant pleural mesothelioma (MPM) and has been shown to be more accurate than CT, MRI, and PET alone in the staging of malignant pleural mesothelioma. PET/CT can also be used to target lesions for biopsy and to assess prognosis, treatment response, and tumor recurrence.
Topics: Humans; Mesothelioma, Malignant; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Pleura; Pleural Neoplasms; Neoplasm Staging; Mesothelioma; Pericardium
PubMed: 36395181
DOI: 10.1097/PAP.0000000000000386 -
Echocardiography (Mount Kisco, N.Y.) Nov 2020
Topics: Heart Neoplasms; Humans; Mesothelioma, Malignant; Pericardium
PubMed: 33047830
DOI: 10.1111/echo.14888 -
Chest Apr 1982
Topics: Adolescent; Diagnosis, Differential; Echocardiography; Heart Neoplasms; Humans; Lymphatic Metastasis; Male; Mesothelioma; Pericardial Effusion; Pericardium; Pleural Neoplasms; Tomography, X-Ray Computed
PubMed: 7067523
DOI: 10.1378/chest.81.4.520 -
Surgical Pathology Clinics Mar 2020Mesothelioma is a rare neoplasm that arises from mesothelial cells lining body cavities including the pleura, pericardium, peritoneum, and tunica vaginalis. Most... (Review)
Review
Mesothelioma is a rare neoplasm that arises from mesothelial cells lining body cavities including the pleura, pericardium, peritoneum, and tunica vaginalis. Most malignant mesotheliomas occur in the chest and are frequently associated with a history of asbestos exposure. The diagnosis of malignant mesothelioma is challenging and fraught with pitfalls, particularly in small biopsies. This article highlights what the pathologist needs to know regarding the clinical and radiographic presentation of mesothelioma, histologic features including subtypes and variants, and recent advances in immunohistochemical markers and molecular testing.
Topics: Biopsy; Humans; Lung; Lung Neoplasms; Magnetic Resonance Imaging; Mesothelioma; Radiography; Tomography, X-Ray Computed
PubMed: 32005436
DOI: 10.1016/j.path.2019.10.001 -
BMC Veterinary Research Jul 2023Pericardial effusions are one of the most common cardiac diseases in dogs. Common causes of haemorrhagic pericardial effusions include neoplasia, such as...
BACKGROUND
Pericardial effusions are one of the most common cardiac diseases in dogs. Common causes of haemorrhagic pericardial effusions include neoplasia, such as hemangiosarcoma, mesothelioma, chemodectoma, and ectopic thyroid tumours, and benign idiopathic pericardial effusion. Distinguishing among reactive mesothelial cells, malignant mesothelioma, and adenocarcinoma in body effusions is a diagnostic challenge. Therefore, the author aimed to discover whether the observed cells were reactive mesothelial, mesothelioma, or adenocarcinoma cells through immunocytochemistry using five markers (cytokeratin, vimentin, desmin, E-cadherin, and calretinin) in a canine patient.
CASE PRESENTATION
A 2.1 kg, spayed female, 10-year-old Yorkshire Terrier dog presented to a local hospital with dyspnoea and was evaluated for pericardial effusion. The presence of pericardial fluid was confirmed, and she was referred to our hospital for further evaluation. In cytological evaluation, cells shed individually or in clusters were observed, along with numerous non-degenerative neutrophils and macrophages. The cells showed binucleation, anisocytosis, anisokaryosis, abnormal nucleoli, abundant basophilic cytoplasm, high nuclear-cytoplasmic ratio, and coarse chromatin. Large atypical multinucleate cells were also observed. Erythrophagia was observed, indicating chronic haemorrhage. Immunocytochemistry using pericardial fluid was positive for cytokeratin, vimentin, desmin, E-cadherin, and calretinin. Therefore, malignant mesothelioma was diagnosed.
CONCLUSIONS
Immunocytochemistry is a very useful diagnostic technique because it can determine whether several fluorescent markers are simultaneously expressed in the same cell. Further, E-cadherin and calretinin can be used for the differential diagnosis of reactive mesothelial cells, malignant mesothelioma, and adenocarcinoma in dogs.
Topics: Female; Dogs; Animals; Pericardial Effusion; Pericardial Fluid; Mesothelioma, Malignant; Calbindin 2; Vimentin; Immunohistochemistry; Desmin; Thymus Neoplasms; Mesothelioma; Heart Neoplasms; Adenocarcinoma; Cadherins; Dog Diseases
PubMed: 37480011
DOI: 10.1186/s12917-023-03655-8 -
Journal of Thoracic Oncology : Official... Dec 2022Primary pericardial mesothelioma (PPM) has no accepted standard-of-care treatment options with management and outcomes often extrapolated from diffuse pleural...
INTRODUCTION
Primary pericardial mesothelioma (PPM) has no accepted standard-of-care treatment options with management and outcomes often extrapolated from diffuse pleural mesothelioma. Disease-specific research is needed to better define PPM. We report our institutional experience with PPM highlighting the potential role for multimodality therapy.
METHODS
Patients with PPM diagnosed by a multidisciplinary team of medical oncologists, thoracic surgeons, thoracic pathologists, and radiologists between January 2011 and January 2022 were followed to February 2022. Clinicopathologic features and treatment outcomes were annotated. Overall survival (OS) was defined from the date of pathologic diagnosis.
RESULTS
The median age at diagnosis of the 12 patients identified with having PPM was 51 (range: 21-71) years old. Most patients were of female sex (n = 8; 67%), 75% of the samples were epithelioid (n = 9), and 25% were nonepithelioid (two sarcomatoid and one biphasic). Most cases (92%, 11 of 12) had expression of at least two mesothelial markers on immunohistochemistry. The median OS of the cohort was 25.9 months. Five patients had an OS greater than 12 months; four of whom received pericardial radiation. Three of the patients who received radiation did so as part of a trimodality approach (surgical resection, adjuvant chemotherapy, and radiation); the OS for patients who received trimodality therapy was 70.3 months versus 8.2 months for those who did not.
CONCLUSIONS
PPM represents a distinct disease with no universally accepted treatment options. Our findings suggest that trimodality therapy may improve outcomes in selected patients with PPM.
Topics: Humans; Female; Young Adult; Adult; Middle Aged; Aged; Lung Neoplasms; Mesothelioma, Malignant; Pleural Neoplasms; Mesothelioma; Combined Modality Therapy; Thymus Neoplasms
PubMed: 36075530
DOI: 10.1016/j.jtho.2022.08.017 -
Journal of Thoracic Oncology : Official... May 2022Substantial changes in the 2021 WHO Classification of Tumors of the Pleura and Pericardium since the 2015 WHO Classification include the following: (1) pleural and... (Review)
Review
Substantial changes in the 2021 WHO Classification of Tumors of the Pleura and Pericardium since the 2015 WHO Classification include the following: (1) pleural and pericardial tumors have been combined in one chapter whereas in the 2015 WHO, pericardial tumors were classified with cardiac tumors; (2) well-differentiated papillary mesothelioma has been renamed well-differentiated papillary mesothelial tumor given growing evidence that these tumors exhibit relatively indolent behavior; (3) localized and diffuse mesothelioma no longer include the term "malignant" as a prefix; (4) mesothelioma in situ has been added to the 2021 classification because these lesions can now be recognized by loss of BAP1 and/or MTAP by immunohistochemistry and/or CDKN2A homozygous deletion by fluorescence in situ hybridization; (5) the three main histologic subtypes (i.e., epithelioid, biphasic, and sarcomatoid) remain the same but architectural patterns and cytologic and stromal features are more formally incorporated into the 2021 classification on the basis of their prognostic significance; (6) nuclear grading for epithelioid diffuse mesothelioma is introduced, and it is recommended to record this and other histologically prognostic features in pathology reports; (7) BAP1, EZH2, and MTAP immunohistochemistry have been found to be useful in separating benign mesothelial proliferations from mesothelioma; (8) biphasic mesothelioma can be diagnosed in small biopsies having both epithelioid and sarcomatoid components even if the amount of one component is less than 10%; and (9) the most frequently altered genes in diffuse pleural mesothelioma include BAP1, CDKN2A, NF2, TP53, SETD2, and SETDB1.
Topics: Biomarkers, Tumor; Homozygote; Humans; In Situ Hybridization, Fluorescence; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Pleura; Pleural Neoplasms; Sequence Deletion; Tumor Suppressor Proteins; Ubiquitin Thiolesterase; World Health Organization
PubMed: 35026477
DOI: 10.1016/j.jtho.2021.12.014 -
Pathologica 1993Pericardial mesothelioma: epidemiological updating on the last decade. In the last decade, 109 cases of primitive malignant pericardial mesothelioma, histologically... (Review)
Review
Pericardial mesothelioma: epidemiological updating on the last decade. In the last decade, 109 cases of primitive malignant pericardial mesothelioma, histologically proved and reported in world medical literature have been added to the 206 cases described in a previous article. This illness, although rare, has been found more frequently in Japan (25 subjects) and in USSR (21 subjects). From the table in annex, the following points emerge: a) On average, pericardial mesothelioma tends to develop in fairly young people (compared to pleural or peritoneal mesothelioma). b) There is more proof that asbestos has an harmful effect on pericardial serosa. c) The most frequent clinical diagnoses refer mainly to acute pericarditis, constrictive pericarditis, cardiac tamponade and sometimes to various types of coronary heart disease, which autoptical examination reveals to be due to the presence of an external compression of the coronary arteries by pericardial mesothelioma. d) This illness, perhaps because of greater research and improved diagnostical means seems to be increasing when compared to the previous period (although this does not appear to be the case in our country).
Topics: Asbestos; Coronary Disease; Female; Heart Neoplasms; Humans; Male; Mesothelioma; Middle Aged; Pericardium
PubMed: 8233654
DOI: No ID Found -
Journal of Clinical Ultrasound : JCU Mar 2019Primary malignant pericardial mesothelioma (PMPM) is an extremely rare tumor, which may appear as a localized or a diffuse mass encasing the heart. Diffuse PMPMs have a...
Primary malignant pericardial mesothelioma (PMPM) is an extremely rare tumor, which may appear as a localized or a diffuse mass encasing the heart. Diffuse PMPMs have a poor prognosis due to the difficulty of surgical excision, whereas localized PMPMs have clear margins, thus facilitating surgical excision. Timely diagnosis and proper treatment are crucial for a favorable prognosis. Eight cases of localized PMPMs have been reported so far, but their characteristics have not been fully described. Herein, we present a patient with localized PMPM and describe the diagnosis methods, treatment, and outcomes of these tumors.
Topics: Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Echocardiography; Heart Neoplasms; Humans; Lung Neoplasms; Male; Mesothelioma; Mesothelioma, Malignant; Middle Aged; Pemetrexed; Pericardium
PubMed: 30450660
DOI: 10.1002/jcu.22673