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Malignant mesothelioma with osseous differentiation
IMAGES IN CARDIOTHORACIC SURGERY
Malignant Mesothelioma With Osseous Differentiation Hon Chi Suen, MBBS, Barbara Sudholt, MD, Wallace M. Anderson, MD, Mazhar H. Lakho, MD, and Bill B. Daily, MD, PhD Departments of Cardiothoracic Surgery, Medicine, and Radiology, Memorial Hospital, Belleville, Illinois
Fig 3.
Fig 1.
Fig 4. Fig 2.
A
n 80-year-old man with a history of prolonged asbestos exposure presented with left-sided chest pain. Chest film showed a left pleural effusion with pleural calcification that had not been present on a film taken after coronary artery bypass surgery 2 years previously (Fig 1). Computed tomographic scan confirmed a large effusion surrounded by a thickened, calcified pleura
Address reprint requests to Dr Suen, Cardiothoracic Surgery Associates, S.C., 12B Park Pl, Swansea, IL 62226; e-mail: [email protected].
© 2002 by The Society of Thoracic Surgeons Published by Elsevier Science Inc
(Fig 2). Serum alkaline phosphatase was markedly elevated. A technetium bone scan showed marked uptake of isotope in the left pleura (Fig 3, anterior view; Fig 4, posterior view) with no evidence of distant bony metastasis. Attempted left thoracentesis and thoracoscopy failed because neither the needle nor the trocar could penetrate the calcified pleura. Rib resection and open pleural biopsy revealed a malignant mesothelioma with osseous differentiation. The patient died 4 months later. Only 15 cases of malignant mesothelioma with osseous differentiation have been described in the literature, and bone scan pictures of this pathology have never been presented before.
Ann Thorac Surg 2002;73:665 • 0003-4975/02/$22.00 PII S0003-4975(01)02740-0
Malignant Mesothelioma With Osseous Differentiation Hon Chi Suen, MBBS, Barbara Sudholt, MD, Wallace M. Anderson, MD, Mazhar H. Lakho, MD, and Bill B. Daily, MD, PhD Departments of Cardiothoracic Surgery, Medicine, and Radiology, Memorial Hospital, Belleville, Illinois
Fig 3.
Fig 1.
Fig 4. Fig 2.
A
n 80-year-old man with a history of prolonged asbestos exposure presented with left-sided chest pain. Chest film showed a left pleural effusion with pleural calcification that had not been present on a film taken after coronary artery bypass surgery 2 years previously (Fig 1). Computed tomographic scan confirmed a large effusion surrounded by a thickened, calcified pleura
Address reprint requests to Dr Suen, Cardiothoracic Surgery Associates, S.C., 12B Park Pl, Swansea, IL 62226; e-mail: [email protected].
© 2002 by The Society of Thoracic Surgeons Published by Elsevier Science Inc
(Fig 2). Serum alkaline phosphatase was markedly elevated. A technetium bone scan showed marked uptake of isotope in the left pleura (Fig 3, anterior view; Fig 4, posterior view) with no evidence of distant bony metastasis. Attempted left thoracentesis and thoracoscopy failed because neither the needle nor the trocar could penetrate the calcified pleura. Rib resection and open pleural biopsy revealed a malignant mesothelioma with osseous differentiation. The patient died 4 months later. Only 15 cases of malignant mesothelioma with osseous differentiation have been described in the literature, and bone scan pictures of this pathology have never been presented before.
Ann Thorac Surg 2002;73:665 • 0003-4975/02/$22.00 PII S0003-4975(01)02740-0