Malignant Pleural Mesothelioma with Marked Lymphatic Involvement: A Report of Two Autopsy Cases.
Reiko IdeguchiKazuto AshizawaSaori AkashiMichiko ShindoKazunori MinamiToshio FukudaJunji IrieMinoru FukudaMasataka UetaniPublished in: Case reports in oncological medicine (2017)
We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass with bronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangitic spread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy was performed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor. Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor. Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis, especially in patients with pleural lesions.
Keyphrases
- computed tomography
- dual energy
- image quality
- contrast enhanced
- lymph node
- positron emission tomography
- pulmonary hypertension
- emergency department
- magnetic resonance imaging
- end stage renal disease
- newly diagnosed
- palliative care
- high resolution
- ejection fraction
- squamous cell carcinoma
- chronic kidney disease
- prognostic factors
- radiation therapy
- atrial fibrillation
- high throughput
- ultrasound guided
- patient reported outcomes
- left ventricular
- pet ct
- fine needle aspiration