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Abdelghani MS, Chapra A, Al‐Qudah B, Bishawi A, Shebani A, Obeidat I, Habib MB. Extrapulmonary tuberculosis presenting as hemorrhagic pleuro-pericardial effusions with pericardial mass. Clin Case Rep 2024; 12:e8619. [PMID: 38562572 PMCID: PMC10982116 DOI: 10.1002/ccr3.8619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 04/04/2024] Open
Abstract
Key Clinical Message Tuberculosis (TB) pericarditis, while uncommon, should be considered in patients with pericardial masses and effusion. Timely recognition and treatment with anti-TB medications are crucial for a successful outcome. Abstract TB pericarditis presenting as a pericardial mass is an unusual and rare manifestation of this disease. We report a 59-year-old South Asian male who presented with a 1-week history of dyspnea and cough. He was found to have a hemorrhagic pericardial mass with a massive pericardial effusion. Pleural fluid analysis was positive for TB. The patient was successfully treated with anti-TB medications. Although rare, tuberculous pericardial involvement should be suspected in patients presenting with symptoms of pericardial masses and effusion.
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Affiliation(s)
| | - Ammar Chapra
- Department of CardiologyHeart Hospital, Hamad Medical CorporationDohaQatar
| | - Bara Al‐Qudah
- Department of Internal MedicineHamad Medical CorporationDohaQatar
| | - Ahmed Bishawi
- Infectious Disease Division, Department of Internal MedicineHamad Medical CorporationDohaQatar
| | - Ahmed Shebani
- Department of Internal MedicineHamad Medical CorporationDohaQatar
| | - Ibrahim Obeidat
- Department of Internal MedicineHamad Medical CorporationDohaQatar
| | - Mhd Baraa Habib
- Department of CardiologyHeart Hospital, Hamad Medical CorporationDohaQatar
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2
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Strange CD, Marom EM, Ahuja J, Shroff GS, Gladish GW, Carter BW, Truong MT. Imaging of Malignant Pleural, Pericardial, and Peritoneal Mesothelioma. Adv Anat Pathol 2023; 30:280-291. [PMID: 36395181 DOI: 10.1097/pap.0000000000000386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Chad D Strange
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Edith M Marom
- Department of Diagnostic Radiology, Chaim Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Girish S Shroff
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gregory W Gladish
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Brett W Carter
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mylene T Truong
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
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3
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Fukasawa N, Agemi Y, Shiba A, Aga M, Hamakawa Y, Miyazaki K, Taniguchi Y, Misumi Y, Shimokawa T, Ono K, Hayashi H, Okamoto H. A case of slowly progressive malignant pericardial mesothelioma suggesting the involvement of BAP1 loss. Respirol Case Rep 2022; 10:e01004. [PMID: 35950141 PMCID: PMC9356387 DOI: 10.1002/rcr2.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022] Open
Abstract
Malignant pericardial mesothelioma (MPM) is a rare tumour that arises from the mesothelial cells of the pericardium. No standard treatment has been established owing to a poor treatment response; therefore, MPM has a poor prognosis. We herein report a rare case of MPM in a 70-year-old man that was diagnosed immunohistopathologically using cell block sections of pericardial fluid and in which long-term survival for more than 3 years was achieved with only periodic pericardial drainage. Immunohistopathological staining investigations, especially BRCA1-associated protein 1 (BAP1) immunostaining using cell block sections of pericardial effusion, are effective in making a diagnosis of MPM. Well-differentiated papillary mesothelioma (WDPM) with BAP1 loss progresses to MPM in the long term, showing that BAP1 loss may induce phenotypical evolution of WDPM. BAP1 loss may also progress to malignant mesothelioma in situ and then to invasive mesothelioma. BAP1 immunohistochemistry should be considered for the early diagnosis of MPM.
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Affiliation(s)
- Naoto Fukasawa
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Yoko Agemi
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Aya Shiba
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Masaharu Aga
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Yusuke Hamakawa
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Kazuhito Miyazaki
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Yuri Taniguchi
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Yuki Misumi
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Tsuneo Shimokawa
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Kyoko Ono
- Department of PathologyKanagawa Cancer CenterYokohamaJapan
| | - Hiroyuki Hayashi
- Department of PathologyYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Hiroaki Okamoto
- Department of Respiratory MedicineYokohama Municipal Citizen's HospitalYokohamaJapan
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4
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Armstrong SM, Thavendiranathan P, Butany J. The pericardium and its diseases. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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5
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Kenchetty PK, Balasundaram S, Rao K. An uncommon aetiology for a common clinical problem: Primary pericardial mesothelioma. THE NATIONAL MEDICAL JOURNAL OF INDIA 2022; 35:14-16. [PMID: 36039621 DOI: 10.25259/nmji_273_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mesothelioma is a tumour arising from the mesothelial cells lining the pleura, pericardium, peritoneum, or the tunica vaginalis of testes. Primary pericardial mesothelioma is a rare tumour that can have varied manifestations and survival in patients with malignant pericardial tumours is generally dismal. The role of asbestos in pericardial mesotheliomas is less well established compared to that in pleural or peritoneal mesotheliomas. The prognosis is generally poor with the treatment options available. We present a middle-aged man with large pericardial effusion secondary to primary pericardial mesothelioma with no previous exposure to asbestos.
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Affiliation(s)
- P Kumar Kenchetty
- Department of Cardiology, Yenepoya Medical College Hospital, Deralakatte, Mangalore 575018, Karnataka, India
| | - Sreekar Balasundaram
- Department of Cardiothoracic and Vascular Surgery, Yenepoya Medical College Hospital, Deralakatte, Mangalore 575018, Karnataka, India
| | - Krishna Rao
- Interventional Cardiologist, Bengaluru, Karnataka, India
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Abstract
PURPOSE OF REVIEW Tumors of the pericardium are rare, but a wide variety of congenital, infectious, inflammatory, and neoplastic processes have been reported. Pericardial tumors can be categorized as non-neoplastic or neoplastic. Neoplastic lesions can be further divided into benign or malignant, with malignancies being either primary or secondary (metastatic). Clinical, radiographic, and pathologic features of the most common entities are discussed. RECENT FINDINGS Metastatic neoplasms involving the heart and pericardium are far more common than primary pericardial neoplasms. Of primary pericardial malignancies, mesothelioma is the most common; notably, cytology of effusion fluid is relatively insensitive to the diagnosis. The prognosis for most malignancies of the pericardium, primary or secondary, is poor. Increasingly, clinically recognized diseases that involve the pericardium include Erdheim-Chester and IgG4-related disease. This article provides a comprehensive review of the most recent literature to develop a structured framework to the differential diagnosis of pericardial tumors.
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7
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Felix ADS, Fonseca VBPD, Segalote RC, Andrade LFD, Palmieri DLDRV, Siciliano APDRV. Pericardial Masses: A Rare Presentation of Tuberculous Pericarditis Documented by 3D Echocardiography. Arq Bras Cardiol 2021; 116:12-16. [PMID: 33566996 PMCID: PMC8118636 DOI: 10.36660/abc.20190876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/22/2020] [Indexed: 01/30/2023] Open
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8
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Raza SS, Ullah I, Awan SK, Nadeem MD, Bashir G. Case Report: Can we differentiate mesothelioma from inflammatory pericardial constriction preoperatively? F1000Res 2020; 9:513. [PMID: 35186278 PMCID: PMC8825643 DOI: 10.12688/f1000research.23998.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2020] [Indexed: 11/20/2022] Open
Abstract
Primary malignant pericardial mesothelioma (PMPM) is a rare cardiac tumor. The patient usually presents with pericardial constriction, usually misdiagnosed and wrongly managed. We present the case of a 21-year-old woman with a history of pericarditis and cardiac tamponade. The patient was referred from a clinic due to nausea, vomiting and ascites with lower extremity edema, soft and watery diarrhea, and right upper quadrant pain. Surgery (sternotomy and partial pericardiectomy) was proposed after looking at the different relevant investigations; it was not until that the patient was operated on that it was established that this wasn't a mere constriction but a malignancy. The patient shortly died after the operation. Pathology made a diagnosis of PMPM. Along with the classical symptoms those who present with level 1 thoracic adenopathy a decision to operate should be very carefully made, this may lead to a misdiagnosis of PMPM which postoperatively results in patient's death.
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Affiliation(s)
| | - Irfan Ullah
- Gastroentrology, Prince Charles Hospital, Merthyr Tydfil, Merthyr Tydfil, UK
| | | | | | - Gulsam Bashir
- Khyber Medical College, Peshawar, KP, 25000, Pakistan
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9
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Tower-Rader A, Kwon D. Pericardial Masses, Cysts and Diverticula: A Comprehensive Review Using Multimodality Imaging. Prog Cardiovasc Dis 2017; 59:389-397. [PMID: 28062266 DOI: 10.1016/j.pcad.2016.12.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
Pericardial masses/tumors, cysts, and diverticula are quite rare. Presentation is variable and often patients may be asymptomatic with pericardial involvement initially only detected at time of autopsy. When patients do present with symptoms they are often non-specific and often mimic other conditions of the pericardium such as pericarditis, pericardial effusion, constriction or tamponade. Therefore, echocardiography and cross-sectional imaging are essential in identifying and characterizing pericardial disease. Imaging findings vary in specificity depending on the type of tumor. The purpose of this review is to describe the role of multi-modality imaging and characteristic findings in patients with pericardial masses/tumors, cysts, and diverticula.
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10
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Pericardial Effusion due to Primary Malignant Pericardial Mesothelioma: A Common Finding but an Uncommon Cause. Case Rep Med 2016; 2016:4810901. [PMID: 28003826 PMCID: PMC5149636 DOI: 10.1155/2016/4810901] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 12/22/2022] Open
Abstract
This case report describes a 37-year-old female who was admitted to our Emergency Department because of shortness of breath. On physical examination, she had dyspnea and tachycardia and blood pressure was 80/50 mmHg with a pulsus paradoxus of 22 mmHg. Neck veins were distended, heart sounds were distant, and dullness was found on both lung bases. Her chest X-ray revealed bilateral pleural effusion and cardiomegaly. On both computed tomography and echocardiography the heart was of normal size and a large pericardial effusion was noted. The echocardiogram showed signs of impending tamponade, so the patient underwent an emergent pericardiocentesis. No infectious etiology was found and she was assumed to have viral pericarditis and was treated accordingly. However, when the pericardial effusion recurred and empirical therapy for tuberculosis failed, a pericardial window was performed. A typical staining pattern for mesothelioma was found on her pericardial biopsy specimen. Since no other mesodermal tissue was affected, a diagnosis of primary malignant pericardial mesothelioma was made. Chemotherapy was not effective and she passed away a year after the diagnosis was made. This case highlights the difficulties in diagnosing this uncommon disease in patients that present with the common finding of pericardial effusion.
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11
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Raeside MC, Gormly K, Neuhaus SJ, Kotasek D, James C. Primary pericardial mesothelioma presenting as multiple pericardial masses on CT. BJR Case Rep 2016; 2:20150295. [PMID: 30364446 PMCID: PMC6195937 DOI: 10.1259/bjrcr.20150295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/20/2015] [Accepted: 10/22/2015] [Indexed: 11/26/2022] Open
Abstract
We present the case of a 67-year-old male who was found to have multiple enhancing pericardial masses on CT imaging for investigation of weight loss and was subsequently diagnosed with primary pericardial mesothelioma. Although rare, pericardial mesothelioma is the most common primary malignancy of the pericardium and should be considered in the differential diagnosis of pericardial effusion, pericardial thickening or discreet pericardial mass. It is important for radiologists to be aware of pericardial mesothelioma as its clinical presentation is non-specific and it may be incidentally noted on radiological studies for investigation of apparently non-related symptoms. The prognosis of primary pericardial mesothelioma is universally poor.
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Affiliation(s)
| | - Kirsten Gormly
- Dr Jones and Partners Medical Imaging, Adelaide, SA, Australia
| | - Susan J Neuhaus
- Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, Australia
| | | | - Craig James
- Adelaide Pathology Partners, Adelaide, SA, Australia
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12
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The Pericardium and Its Diseases. Cardiovasc Pathol 2016. [DOI: 10.1016/b978-0-12-420219-1.00015-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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13
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Gong W, Ye X, Shi K, Zhao Q. Primary malignant pericardial mesothelioma-a rare cause of superior vena cava thrombosis and constrictive pericarditis. J Thorac Dis 2015; 6:E272-5. [PMID: 25590007 DOI: 10.3978/j.issn.2072-1439.2014.11.36] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 09/23/2014] [Indexed: 11/14/2022]
Abstract
Primary malignant pericardial mesothelioma (PMPM) is an extremely rare, highly lethal and often misdiagnosed tumor. We report a 60-year-old woman complaining of dry cough, shortness of breath and exertional dyspnea due to a large pericardial effusion. The pericardial fluid volume declined after pericardiocentesis; analysis of the fluid revealed malignant cells and was negative for tuberculosis. Subsequently, the patient developed a compression of the superior vena cava and pericardial constriction. The patient's symptoms marginally improved after partial pericardiectomy, and a diagnosis of pericardial mesothelioma was made on pathology. However, her symptoms continued to aggravate, and she died 8 months after presentation. Pericardial mesothelioma should be discovered earlier to treat patients who develop repeatedly pericardial effusion after pericardiocentesis and pericardial tamponade or those develop constrictive pericarditis.
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Affiliation(s)
- Wenhui Gong
- 1 Department of Cardiac Surgery, Ruijin Hospital of Shanghai Jiaotong University School of Medicine, Shanghai 200025, China ; 2 Department of Cardio-thoracic Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Xiaofeng Ye
- 1 Department of Cardiac Surgery, Ruijin Hospital of Shanghai Jiaotong University School of Medicine, Shanghai 200025, China ; 2 Department of Cardio-thoracic Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Kaihu Shi
- 1 Department of Cardiac Surgery, Ruijin Hospital of Shanghai Jiaotong University School of Medicine, Shanghai 200025, China ; 2 Department of Cardio-thoracic Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Qiang Zhao
- 1 Department of Cardiac Surgery, Ruijin Hospital of Shanghai Jiaotong University School of Medicine, Shanghai 200025, China ; 2 Department of Cardio-thoracic Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
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14
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McRee CW, Mergo P, Parikh P, Pollak A, Shapiro BP. Modern advances in cardiovascular imaging: cardiac computed tomography and cardiovascular MRI in pericardial disease. Future Cardiol 2014; 10:769-79. [DOI: 10.2217/fca.14.61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
ABSTRACT The pericardium is characterized by a two-layer sac that surrounds the heart and provides an enclosed, lubricated space. Diseases of the pericardium may occur due to active inflammation, scar, calcification or effusion. While clinical, ECG and hemodynamic evaluation have been the established methods for the diagnosis of pericardial disease, advances in cardiac computed tomography and cardiovascular MRI provide complementary tools for diagnostic, prognostic and therapeutic assessment.
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Affiliation(s)
- Chad W McRee
- Department of Cardiology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Patricia Mergo
- Department of Cardiology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Pragnesh Parikh
- Department of Cardiology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Amy Pollak
- Department of Cardiology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Brian P Shapiro
- Department of Cardiology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA
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15
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Kerger BD, James RC, Galbraith DA. Tumors that mimic asbestos-related mesothelioma: time to consider a genetics-based tumor registry? Front Genet 2014; 5:151. [PMID: 24910640 PMCID: PMC4038924 DOI: 10.3389/fgene.2014.00151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 05/08/2014] [Indexed: 01/27/2023] Open
Abstract
The diagnosis of mesothelioma is not always straightforward, despite known immunohistochemical markers and other diagnostic techniques. One reason for the difficulty is that extrapleural tumors resembling mesothelioma may have several possible etiologies, especially in cases with no meaningful history of amphibole asbestos exposure. When the diagnosis of mesothelioma is based on histologic features alone, primary mesotheliomas may resemble various primary or metastatic cancers that have directly invaded the serosal membranes. Some of these metastatic malignancies, particularly carcinomas and sarcomas of the pleura, pericardium and peritoneum, may undergo desmoplastic reaction in the pleura, thereby mimicking mesothelioma, rather than the primary tumor. Encasement of the lung by direct spread or metastasis, termed pseudomesotheliomatous spread, occurs with several other primary cancer types, including certain late-stage tumors from genetic cancer syndromes exhibiting chromosomal instability. Although immunohistochemical staining patterns differentiate most carcinomas, lymphomas, and mestastatic sarcomas from mesotheliomas, specific genetic markers in tumor or somatic tissues have been recently identified that may also distinguish these tumor types from asbestos-related mesothelioma. A registry for genetic screening of mesothelioma cases would help lead to improvements in diagnostic criteria, prognostic accuracy and treatment efficacy, as well as improved estimates of primary mesothelioma incidence and of background rates of cancers unrelated to asbestos that might be otherwise mistaken for mesothelioma. This information would also help better define the dose-response relationships for mesothelioma and asbestos exposure, as well as other risk factors for mesothelioma and other mesenchymal or advanced metastatic tumors that may be indistinguishable by histology and staining characteristics.
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16
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Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, Hung J, Garcia MJ, Kronzon I, Oh JK, Rodriguez ER, Schaff HV, Schoenhagen P, Tan CD, White RD. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 2013; 26:965-1012.e15. [PMID: 23998693 DOI: 10.1016/j.echo.2013.06.023] [Citation(s) in RCA: 405] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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17
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Abstract
The pericardium is an important structure, and there are many diseases that affect the pericardium and the heart. Often, surgery is required for drainage or removal of the pericardium, but techniques are not standardized, and there is controversy, especially with regard to treatment of constrictive pericarditis. This paper reviews surgical methods for the treatment of inflammatory and constrictive pericarditis and presents early and late outcome of operation.
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Affiliation(s)
- Yang Hyun Cho
- Division of Cardiovascular Surgery, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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18
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Primary pericardial mesothelioma: a rare entity. Case Rep Oncol Med 2013; 2013:283601. [PMID: 23840993 PMCID: PMC3697233 DOI: 10.1155/2013/283601] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 06/05/2013] [Indexed: 11/30/2022] Open
Abstract
Primary pericardial malignant mesothelioma is an extremely rare neoplasm that arises from the pericardial mesothelial cell layers. Clinical symptoms and signs are frequently nonspecific, and the diagnosis is usually made after surgery or at autopsy. There is no standard treatment for pericardial mesothelioma; nonetheless, radical surgery is the mainstay of therapy for localized disease. The neoplasm is highly aggressive and carries a dismal prognosis with an overall survival of less than six months. This paper presents a case study of a 68-year-old patient with a primary pericardial malignant mesothelioma. Radiologic evaluation revealed a small nodule in the posterior pericardium with pericardial and bilateral pleural effusions. The diagnosis was established after surgery by histological and immunohistochemical studies. The patient remained alive and free of disease for about 24 months; however, due to rapid local recurrence, the patient died 27 months after the surgical treatment.
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19
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Gupta N. Intrapericardial hemangioma: a case report. J Clin Diagn Res 2013; 7:169-70. [PMID: 23449754 DOI: 10.7860/jcdr/2012/4714.2699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 09/19/2012] [Indexed: 11/24/2022]
Abstract
Hemangiomas of the pericardium are very rare primary pericardial tumours. Very few cases of pericardial hemangioma have been reported in the literature till date. We are reporting a case of a 40 years old male who presented with the complaints of chest discomfort and palpitation on exertion, of 3 months duration. ECHO and Colour Doppler ECHO which were done, revealed a large heterogeneous mass which measured 7.6 × 7.1cms, which was possibly attached to the roof and the anterior surface of the left atria, which was possibly a myxoma. Based on the radiological findings, a diagnosis of left atrial myxoma was considered. However, intra operatively, an encapsulated mass was seen within the pericardium, which was successfully excised and sent for histopathology. The histopathological examination revealed an intrapericardial hemangioma. This case has been reported on account of its extreme rarity.
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Affiliation(s)
- Nalini Gupta
- Department of Histopathology SRL (Religare) Reference Laboratory , Gurgaon, Haryana, India
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20
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ACCF 2012 expert consensus document on practical clinical considerations in the interpretation of troponin elevations: a report of the American College of Cardiology Foundation task force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2012; 60:2427-63. [PMID: 23154053 DOI: 10.1016/j.jacc.2012.08.969] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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21
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Abstract
Pericardial lymphangiomas are extremely rare benign tumors of lymphatic origin that are usually diagnosed in children. These tumors are often asymptomatic but can cause symptoms secondary to mass effect. We report a case of a giant pericardial lymphangioma that was incidentally discovered in a 58-year-old woman and present imaging, surgical, and pathologic correlations.
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22
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Primary malignant pericardial mesothelioma - a rare cause of pericardial effusion and consecutive constrictive pericarditis: a case report. J Med Case Rep 2009; 3:9256. [PMID: 19918293 DOI: 10.4076/1752-1947-3-9256] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2008] [Accepted: 03/13/2009] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Primary malignant pericardial mesothelioma is a very rare pericardial tumor of unknown etiology. CASE PRESENTATION A 61-year-old Caucasian woman was admitted to our hospital complaining of exertional dyspnea due to a large pericardial effusion. Intrapericardial fluid volume declined after repeated pericardiocentesis, but the patient progressively developed a hemodynamically relevant pericardial constriction. Pericardiectomy revealed a pericardial mesothelioma. Subsequently, four cycles of chemotherapy (dosage according to recently published trials) were administered. The patient remained asymptomatic, and there was no recurrence of the tumor after three years. CONCLUSION Pericardial mesothelioma should be considered and managed appropriately in non-responders to pericardiocentesis, and in patients who develop constrictive pericarditis late in their clinical course.
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Butz T, Faber L, Langer C, Körfer J, Lindner O, Tannapfel A, Müller KM, Meissner A, Plehn G, Trappe HJ, Horstkotte D, Piper C. Primary malignant pericardial mesothelioma - a rare cause of pericardial effusion and consecutive constrictive pericarditis: a case report. J Med Case Rep 2009. [PMID: 19918293 PMCID: PMC2767155 DOI: 10.1186/1752-1947-0003-0000009256] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Primary malignant pericardial mesothelioma is a very rare pericardial tumor of unknown etiology. Case presentation A 61-year-old Caucasian woman was admitted to our hospital complaining of exertional dyspnea due to a large pericardial effusion. Intrapericardial fluid volume declined after repeated pericardiocentesis, but the patient progressively developed a hemodynamically relevant pericardial constriction. Pericardiectomy revealed a pericardial mesothelioma. Subsequently, four cycles of chemotherapy (dosage according to recently published trials) were administered. The patient remained asymptomatic, and there was no recurrence of the tumor after three years. Conclusion Pericardial mesothelioma should be considered and managed appropriately in non-responders to pericardiocentesis, and in patients who develop constrictive pericarditis late in their clinical course.
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