Chest
Selected ReportsPericardial Mesothelioma
Section snippets
CASE REPORT
Eight weeks prior to admission, this previously healthy, 17-year-old high school boy had sharp, intermittent, nonradiating, substernal chest pain. The pain increased with recumbency, exercise, or deep inspiration, and decreased with rest or erect posture. During this time he lost 6.75 kg and felt weak.
Two weeks before admission he was hospitalized elsewhere for the chest pain and was found to be afebrile but to have a three-component pericardial friction rub. An echocardiogram was interpreted
DISCUSSION
The preceding history of exudative pericarditis followed by pleural effusions and terminated by acute, fatal cardiac tamponade, is similar to previously reported cases of pericardial mesothelioma.3, 4, 5, 6, 7 The presence of microscopic pleural metastases in this case raises questions about the pericardium as the primary site of tumor by the rigid criteria of Anderson and Hansen,5 who restricted primary pericardial mesothelioma to tumor involvement of the pericardium and mediastinal lymph
ACKNOWLEDGMENTS
The authors wish to thank Dr. Daniel Arensberg for clinical assistance, Dr. Howard M. Austin for assistance with computed tomograms, Dr. James L. Clements, Jr, for radiologic interpretations, and Dr. Joel M. Felner for assistance with echocardiographic interpretations.
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Cited by (23)
Diffuse Primary Malignant Pericardial Mesothelioma With Myocardial involvement: A Comprehensive Assessment Using Multimodel Echocardiography
2022, Current Problems in CardiologyCitation Excerpt :Echocardiography remains the primary choice in the diagnosis of diffuse PMPM with myocardial involvement. By searching the databases of Web of Science, Medline, and Pubmed, 39 patients with diffuse PMPM have been detected by echocardiography.7-40 According to the literature review, the most common echocardiographic features were pericardial effusion, pericardial masses and thickened pericardium (Supplementary Table 1).
Recurrence of Pericardial Mesothelioma Affecting the Myocardium After Pericardial Resection
2018, Annals of Thoracic SurgeryCitation Excerpt :The histologic types diagnosed include epithelioid, mixed, and sarcomatoid histology. Epithelial, as in our patient, has the better prognosis [4]. It has also been described as having a possible relation with asbestos exposure, mainly associated with cases with coexistent pleural disease [5].
Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis
2017, Annals of EpidemiologyCitation Excerpt :Of the reported cases, about two-thirds (69%) were male, with a mean reported age of 47 years among males (range, 20 months to 85 years) and 50 years among females (range, 19–76 years). A number of cases reported in the literature occurred among children or young adults under the age of 20 (e.g., [19,46–51]). Between 1953 and 2009, five reviews were published that systematically identified reported pericardial MM cases in the literature [11,15,28,32,37].
Pericardial Masses, Cysts and Diverticula: A Comprehensive Review Using Multimodality Imaging
2017, Progress in Cardiovascular DiseasesCitation Excerpt :Lymphomas are typically hypo- or isoattenuating with heterogenous enhancement with iodinated contrast administration.28 Mesothelioma can be identified as an irregular, diffuse thickening of the pericardium with effusion, with an appearance very similar to metastatic involvement.21,28,33,43 Lymphadenopathy can also be identified by cCT and is an important associated finding suggestive of malignancy.
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
2013, Journal of the American Society of EchocardiographyCitation Excerpt :Disruption of the pericardial sac; presence of hemorrhagic effusion; invasion into the epicardial fat tissue, myocardium, or a cardiac chamber; and mediastinal adenopathy are characteristics of a malignancy with an aggressive nature.8 A malignant pericardial mesothelioma may present as a PEff with pericardial nodules or plaques on CT.170,171 Benign tumors of the pericardium include lipomas, which demonstrate low-attenuation fat (i.e., negative Hounsfield units) on CT, and teratomas, which present as masses containing both fat and high-attenuating calcium on CT. Tissue characterization in pericardial tumor evaluation by MR is superior to that of echocardiography and CT.8 Most malignant soft-tissue tumors of the pericardium have signal-intensity characteristics similar to myocardium on T1W SE imaging, with the exception of melanoma, which has high intensity because of short T1 effects from paramagnetic metals bound by melanin,9,48,172 and liposarcoma, which has high signal intensity because of a largely fatty content responding to fat suppression techniques.8,48,59
Primary pericardial mesothelioma
2001, Cardiovascular Pathology