Diffuse intrapulmonary malignant mesothelioma presenting with miliary pulmonary nodules: A case report

Tomoyuki Hida, Makoto Hamasaki, Shinji Matsumoto, Sosei Abe, Koji Takakura, Kenzo Hiroshima, Kazuki Nabeshima

研究成果: Contribution to journalArticle査読

5 被引用数 (Scopus)

抄録

A 67-year-old male with a history of asbestos exposure presented with fever, cough, and dyspnea and was found to have diffuse granular shadowing in both lungs, right pleural effusion, and hilar and mediastinal lymphadenopathy upon chest computed tomography. For definitive diagnosis, a thoracoscopic lung biopsy was performed. Intraoperative findings showed no remarkable macroscopic changes in the visceral and parietal pleura, although a high level of hyaluronic acid in the pleural effusion was noted. Histological findings showed proliferation of atypical cells with round-to-oval nuclei, prominent nucleoli, and eosinophilic cytoplasms. These cells were arranged into sheets or tubules and were located predominantly in the lung parenchyma. Lymphovascular invasion was conspicuous. Immunohistochemically, tumor cells were positive for calretinin, D2-40, and CK5/6, focally positive for Ber-EP4, but negative for WT-1, TTF-1, CEA, and MOC31. Fluorescence in situ hybridization for the tumor suppressor p16 revealed homozygous deletion in the tumor cells. Therefore, we diagnosed the tumor as diffuse intrapulmonary malignant mesothelioma (DIMM). The patient had a poor response to chemotherapy and died 1 year after diagnosis. Although rare, DIMM should be considered when patients present with multiple, tiny intrapulmonary nodules, regardless of macroscopic pleural changes. Furthermore, this is the first report on p16 status in DIMM.

本文言語英語
ページ(範囲)318-323
ページ数6
ジャーナルPathology International
65
6
DOI
出版ステータス出版済み - 6 1 2015
外部発表はい

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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