Malignant pleural mesothelioma with constrictive pericarditis as the first manifestation: A case report

• Published in: Clinical case reports Vol. 11; no. 6; pp. e7555 - n/a
• Main Authors: He, Cheng‐Peng, Tu, Di‐Wei, Zhang, Ting‐Wei, Zhang, Qian, Zhang, Qiang, Kang, Di, Wang, Ying‐Ying, Li, Ying‐Ying, Zhang, Bin, Han, Sha‐Sha, Li, Hong‐Bo
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.06.2023; John Wiley and Sons Inc; Wiley
• Subjects: Abdomen; Asbestos; Biopsy; Case Report; Case reports; Chemotherapy; constrictive pericarditis; Dyspnea; Hospitals; Hyperplasia; Laboratories; Lymphatic system; malignant pleural mesothelioma; Mesothelioma; Metastasis; Pain; Pathology; Pericarditis; Pericardium; Pleural effusion; Respiratory Medicine; Surgeons; Thoracic surgery; Ultrasonic imaging; constrictive pericarditis; pericardium; malignant pleural mesothelioma
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.7555

Pleural mesothelioma (PM) with pericardial involvement is extremely rare. We now report a rare case of malignant PM with constrictive pericarditis as the first presentation. A 59‐year‐old male diagnosed with constrictive pericarditis underwent pericardiectomy and pericardial pathology revealed mesothelial hyperplasia. Eight months after surgery, the patient was admitted to the hospital with chest tightness and wheezing for 5 days. Computed tomography scan of the chest showed a left lung expansion insufficiency, limited bilateral pleural thickening, pericardial thickening with a small amount of pericardial effusion, and multiple enlarged lymph nodes in the mediastinum, bilateral supraclavicular fossa, bilateral cervical roots, and right axilla. The pleural malignancy should be possibly considered. Pathology after pleural puncture showed malignant PM. Pathology after left supraclavicular lymph node puncture biopsy showed metastatic malignant mesothelioma. The diagnosis of this patient was clear. Although malignant PM rarely involves the pericardial constriction, we cannot ignore the fact that malignant PM involves the pericardium. The patient has been diagnosed with constrictive pericarditis, accompanied by pleural thickening and pleural effusion. Without other pathogenic factors, pleural biopsy should be aggressively performed in patients with constrictive pericarditis to determine the cause. Pleural pathology: malignant mesothelioma demonstrated.