An Autopsy Case of Pseudomesotheliomatous Adenocarcinoma of the Lung

Published on Jan 1, 2006in Haigan
· DOI :10.2482/HAIGAN.46.145
Yuichi Tambo5
Estimated H-index: 5
Toshiyuki Kita15
Estimated H-index: 15
+ 3 AuthorsShinji Nakao59
Estimated H-index: 59
背景.偽中皮腫性肺癌(pseudomesotheliomatous carcinoma of the lung:PMCL)は,臓側胸膜へのびまん性浸潤を特徴とし,組織学的に末梢性肺癌であることが確認されるものと定義される.今回我々はPMCLと診断した1剖検例を経験したので報告する.症例.71歳男性.2003年5月右胸痛,呼吸困難を主訴に外来受診し,胸部単純写真にて右側胸水を認め,入院となった.胸水細胞診にて腺癌細胞が検出され,全身検査の結果,肺腺癌(cT4N3M0 stage IIIB)と診断した.胸腔ドレナージ後,化学療法を繰り返し行ったが,診断から16ヶ月の経過で腫瘍死した.剖検の結果,右肺内には腫瘍性病変を認めなかったが,肺全体を取り囲むように胸膜は肥厚していた.臓側胸膜に沿った部位に癌組織を認め,免疫染色にてCEA, TTF-1陽性,calretinin陰性,であり,PMCLと診断した.結論.肺内の原発巣が不明な悪性胸水の症例においては,PMCLも念頭におき,胸水細胞診のみではなく可能な限り免疫組織学的検査も行うことが必要であると考えられた.
#1Richard Attanoos (Cardiff and Vale University Health Board)H-Index: 38
#2Allen R. Gibbs (Cardiff and Vale University Health Board)H-Index: 38
Aims: To undertake a clinicopathological study of diffuse serosal neoplasms of epithelial histogenesis which clinically and pathologically mimic malignant pleural mesothelioma. Methods and results: Over a 10-year (1990–2000) study period 53 carcinomas mimicking diffuse pleural mesothelioma (‘pseudomesotheliomatous’ carcinoma) were identified. The study group comprised 50 men and three females, age range 33–77 (median 68) years. In 46 (87%) cases there was a history of smoking and in 40 (76%) cas...
77 CitationsSource
#1Richard Attanoos (Cardiff University)H-Index: 38
#2S K SuvarnaH-Index: 1
Last. Allen R. GibbsH-Index: 38
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BACKGROUND Three cases of diffuse malignant vascular tumours of the pleura are described which mimicked malignant mesothelioma clinically and pathologically (so called “pseudomesothelioma”). All had occupational histories of exposure to asbestos. The relationship of these tumours to mesothelioma and asbestos exposure is discussed. METHODS To examine the histogenetic relationship between mesothelioma and these three tumours an immunohistochemical analysis of vascular marker (CD31, CD34, and Von W...
48 CitationsSource
#1Michael Koss (SC: University of Southern California)H-Index: 93
#2Marian V. Fleming (SC: University of Southern California)H-Index: 14
Last. Liselotte Hochholzer (SC: University of Southern California)H-Index: 25
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We report 29 cases of adenocarcinomas whose clinical, gross, and microscopic appearance resembled diffuse malignant pleural mesothelioma. Initial criteria for inclusion in the study included availability of an open pleural biopsy or decortication specimen and microscopic evidence of neutral (periodic acid-Schiff positive) mucin in the tumor. The median age of the patients was 63 years (range, 31 to 78 years), with a peak age in the seventh decade. There were 24 men and five women. Thirteen of th...
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#1M. P. G. LeersH-Index: 1
#2M. M. J. AartsH-Index: 1
Last. P. H. M. H. TheunissenH-Index: 1
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Aims: To assess the diagnostic accuracy of combinations of antibodies in the differential diagnosis of metastatic carcinomas and mesotheliomas in pleural lesions. Methods and results: The specificity and sensitivity of the commercially available antibodies Ber-EP4, MOC-31, CEA, B72.3, CD15, E-cadherin and calretinin were evaluated using an indirect immunoperoxidase staining technique. This technique was applied to formalin-fixed, paraffin-embedded tissue blocks of pleural lesions. Twenty-one pat...
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The distinction between pleural mesothelioma and peripheral pulmonary adenocarcinoma involving the pleura continues to be a diagnostic problem in surgical pathology. In recent years, the use of various immunohistochemical markers to facilitate this differential diagnosis has become common. In this study, the value of monoclonal antibodies 44-3A6, SM3, HBME-1, and thrombomodulin is compared in the differentiation of these conditions. Fifteen (68.2%) of 22, and 10 (52.6%) of 19 mesotheliomas stain...
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#1J. CloverH-Index: 1
#2J. OatesH-Index: 1
Last. C. EdwardsH-Index: 1
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Aims: Previous studies using frozen material have suggested that cytokeratin 5 is expressed by pleural mesothelioma but not by adenocarcinoma. In the present study, reactions for cytokeratins 5 and 6 were investigated in 33 pleural mesotheliomas and 27 secondary adenocarcinomas of the pleura using formalin-fixed, paraffin-embedded material and a commercially available antibody (anti-cytokeratin 5/6). Methods and results: All of the adenocarcinomas originated in the peripheral lung. The epithelio...
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#1Richard Attanoos (University Hospital of Wales)H-Index: 38
#2H. Goddard (University Hospital of Wales)H-Index: 2
Last. Allen R. Gibbs (University Hospital of Wales)H-Index: 9
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The aim of this study was to examine the expression of three putative mesothelioma-binding antibodies, thrombomodulin, OV 632 and HBME-1 in 42 malignant mesotheliomas (27 pleural and 15 peritoneal) and 32 pulmonary adenocarcinomas. Evaluation of their use in differentiating between the mesotheliomas and pulmonary adenocarcinomas was assessed. Thrombomodulin was expressed by 22 of 42 (52%) mesotheliomas but was seen in eight of 12 pure epithelial-type mesotheliomas of the pleura and in all four p...
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#1Cesar A. Moran (AFIP: Armed Forces Institute of Pathology)H-Index: 21
#1Cesar A. Moran (AFIP: Armed Forces Institute of Pathology)H-Index: 76
Last. Michael N. Koss (AFIP: Armed Forces Institute of Pathology)H-Index: 6
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Five smooth muscle tumours presenting as pleural neoplasms are presented. The patients were three women and two men aged between 21 and 69 years (mean = 45 years). Clinically, one patient presented with chest pain, one with empyema and the other three were asymptomatic. Two of the tumours were located in the left side of the chest cavity and three in the right side. In four cases, the lesions presented as solitary pleural-based masses that varied in size from 10-18 cm in greatest dimension ; in ...
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#1Masaharu NomuraH-Index: 7
#2Masaki FujimuraH-Index: 53
Last. Masanobu KitagawaH-Index: 33
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画像上, 胸膜中皮腫に類似した肺小細胞癌の1例を経験した. 症例は66歳男性, 検診により胸部異常陰影を指摘され来院した. 画像上多発性の右胸膜腫瘤像が認められ, 胸膜中皮腫が疑われた. 気管支鏡所見に異常なく, 腫瘤部の生検も不能であったため, CTガイド下に経皮針生検を施行した. 生検標本では肺小細胞癌と診断された. 化学療法により腫瘍は殆ど消失した.
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#1C. Boutin (AMU: Aix-Marseille University)H-Index: 1
#2F. Rey (AMU: Aix-Marseille University)H-Index: 1
Background. To compare the diagnostic value of thoracoscopic biopsy, fluid cytology, and Abrams needle biopsy, the authors analyzed prospectively the records of 188 patients with malignant pleural mesothelioma examined between 1973 and 1990. Symptoms were pleural effusion in 173 patients, empyema in 1, spontaneous pneumothorax in 1, and radiologic tumor without effusion in 13. Methods. Thoracoscopy was performed using a rigid thoracoscope under local anesthesia with neuroleptanalgesia. A total o...
306 CitationsSource
Cited By2
#1Junichi Okamoto (Nippon Medical School)H-Index: 8
#2Hirotoshi Kubokura (Nippon Medical School)H-Index: 11
Last. Jitsuo Usuda (Nippon Medical School)H-Index: 25
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The form and timing of the local recurrence of lung cancer can be unpredictable and unexpected. Pseudomesotheliomatous adenocarcinoma is a rare tumor that mimics malignant pleural mesothelioma both clinically and pathologically. Distinguishing pseudomesotheliomatous adenocarcinoma from malignant pleural mesothelioma on the basis of clinical findings can be difficult; therefore a biopsy is usually required for diagnosis. Here we report on a 73‑year‑old Japanese man who presented with extensive di...