1/24. Localized malignant mesothelioma of the pleura.We describe a case of malignant pleural mesothelioma appearing as a solitary pleural tumor in a 56-year-old Japanese man with no history of exposure to asbestos. A chest radiograph revealed an isolated extrapulmonary mass in the left hemithorax. The patient underwent tumor resection, but the tumor later recurred on the contralateral pleura. The patient developed cerebral metastases and died 16 months after the initial surgery. The resected tumor was sessile with broad-based pleural attachment. Microscopically, the tumor was composed of interlacing fascicles of plump spindle cells intermixed with few polygonal cells. Most of the tumor cells showed positive immunoreactivity for cytokeratins (AE1 and AE3) and vimentin. Many of the tumor cells were positive for epithelial membrane antigen, and a few were positive for desmin. In contrast, the tumor cells were consistently negative for carcinoembryonic antigen, epithelial antigen BerEP4, calretinin, S-100 protein, neuron-specific enolase, muscle actin antigen HHF35, alpha-smooth muscle actin antigen and CD34. Ultrastructurally, the tumor cells had diffusely distributed cytoplasmic intermediate filaments, desmosome-like junctions, and a few microvilli. Some tumor cells contained cytoplasmic tonofilaments. Immunohistochemical and ultrastructural findings supported the mesothelial nature of the tumor, and led us to diagnose this tumor as a sarcomatoid localized malignant mesothelioma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/24. Malignant mesothelioma: PAS-diastase positivity and inversion of polarity in intravascular tumour.AIMS: periodic acid-Schiff (PAS)-diastase-positive material was identified within pseudoglandular structures within the small intravascular component of two pleural malignant mesotheliomas. The aim of this study was to ascertain the nature of this material and to asses the polarity of the cells forming the pseudoglandular structure. methods AND RESULTS: immunohistochemistry was performed using antibodies to laminin and type IV collagen and the antibody HBME-1. These demonstrated the material to be basement membrane rather than mucin. The apical polarity marker HBME-1 was not related to the internal pseudoglandular structure but stained the periphery of intravascular tumour clumps. CONCLUSIONS: Pseudoluminal PAS-diastase-positive material in malignant mesothelioma may easily be mistaken for epithelial mucin, leading to an erroneous diagnosis of adenocarcinoma. The presence of basement membrane material in pseudolumina, as defined by the presence of laminin and type IV collagen, surrounded by tumour cells whose external surface expresses the apical polarity marker HBME-1 implies inversion of polarity of tumour cells within vascular spaces.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/24. Malignant mesothelioma of the tunica vaginalis propria testis in a patient with asbestos exposure. A case report.A case of malignant mesothelioma arising from the tunica vaginalis propria testis is described. The nature of this tumor is evidenced by in situ malignant change of the mesothelial lining as well as by extensive lymphatic and local tissue invasion. This is the first report of a malignant mesothelioma of the tunica vaginalis associated with asbestos exposure and may be epidemiologically as well as clinically important.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/24. A case of primary malignant pericardial mesothelioma.Primary malignant pericardial mesothelioma (PMPM) is an exceedingly rare tumour. One of the largest necropsy series gave an incidence of primary pericardial tumours of 0.0022%, of which mesothelioma is the most common type. In a Canadian epidemiological survey, the annual incidence of PMPM was reported to be one in 40 million. A male predominance of the disease has been described, and the majority of cases occur in the fourth to seventh decades of life. There has been no definite association between asbestos exposure and pericardial disease. Due to its generally late presentation and poor response to therapy, the prognosis is very poor. The present report discusses the case of a 43-year-old man who presented with cardiac tamponade and was subsequently diagnosed with PMPM. cardiac tamponade is a known complication of the malignancy, but it is rarely the first manifestation of cancer. The patient's clinical course was a result of the aggressive nature of PMPM. Effusive constrictive pericarditis and restrictive cardiomyopathy were likely contributors to this patient's disease burden. These processes should be considered and managed appropriately in patients who do not respond to pericardiocentesis or pericardial window as treatment for pericardial tamponade.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/24. Malignant pleural mesothelioma: a case report.OBJECTIVE: The aim of this study was to discuss a case of malignant pleural mesothelioma (MPM) that presented to a chiropractic teaching clinic and review the pathophysiology of diseases associated with asbestos exposure. CLINICAL FEATURES: An 86-year-old woman had right-sided back pain at the thoracolumbar junction for 3 months; this pain prevented her from exercising on a daily basis. She was alert and oriented but in obvious distress because of her back pain. Breath sounds were decreased on the right in the posterior and lower lobes, with dull percussion and increased tactile fremitus. A significant collection of pleural effusion was seen on the right side on plain film radiographs. A chest computed tomography with contrast showed a large right-sided pleural effusion with small consolidation at the right lung base suggestive of pleural or pulmonary malignancy and highly suspicious for MPM. Further questioning about asbestos exposure revealed that her husband was a maintenance worker. An extrapleural pneumonectomy was performed, and specimens of parietal and visceral pleura were sent for pathological, which revealed a definitive diagnosis of spindle cell mesothelioma. INTERVENTION AND OUTCOME: The patient was diagnosed with MPM, and a surgical therapy option was considered because of the aggressive nature of the lesion and her advanced age. An extrapleural pneumonectomy was performed with removal of parietal and visceral pleura, right lower lobe, and right hemidiaphragm. CONCLUSION: This is an unusual case of advanced MPM that is most likely from indirect asbestos exposure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/24. Malignant peritoneal mesothelioma in childhood with long-term survival.A diffuse, well-differentiated, malignant peritoneal mesothelioma (MPM) developed in a nine-year-old girl. She received limited chemotherapy and radiation therapy and is alive and well without clinical evidence of disease 109 months after diagnosis. The neoplastic cells stained immunohistochemically for cytokeratin and epithelial membrane antigen but were unreactive with B72.3, anti-carcinoembryonic antigen, and anti-Leu-M1. Ultrastructurally, the tumor cells had abundant desmosomes, numerous tonofilament bundles, and variable-length microvilli. These findings confirm the mesothelial nature of the cells. Features consistent with malignancy included dna aneuploidy by flow cytometric analysis and diffuse peritoneal involvement. The three previously described survivors with MPM were also premenarchal girls. Some MPMs in premenarchal girls have an indolent biologic behavior similar to that of low-grade peritoneal serous neoplasia or well-differentiated papillary mesothelioma in adult women.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/24. Benign multicystic mesothelial proliferation of the peritoneum: immunohistochemical and electron microscopical study of a case and review of the literature.We report a case of benign multicystic mesothelial proliferation (the so-called multicystic peritoneal mesothelioma) arising multifocally in the abdomen of a 46-year-old white man. His anamnesis showed an 8-year history of intermittent pain in the right lower abdominal quadrant. Mucin stains, immunohistochemistry, and electron microscopy confirmed the mesothelial origin of the lesion. review of the available literature allowed us to find another 85 reported cases of benign multicystic mesothelial proliferations of the peritoneum. Out of these cases, eighteen only occurred in men, the majority being reported in middle-aged women mostly with complaints of abdominal pain. Electron microscopy or immunohistochemistry are needed to make a differential diagnosis towards other multicystic lesions, such as peritoneal cystic lymphangioma. Although multicystic mesothelial proliferations of the peritoneum have often been regarded as benign neoplasms, the true nature--neoplastic or hyperplastic--of these lesions still remains greatly elusive. Therefore, we believe that the unbinding term benign multicystic mesothelial proliferation (first used with regard to the unique hitherto reported case arisen in the pleural cavity) should be considered at present more appropriate to indicate even these peritoneal lesions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/24. Benign cystic mesothelioma in a male.We present a case of a male with benign cystic mesothelioma of the peritoneum. The literature is reviewed for previous case reports of this rare lesion in males. Benign cystic mesotheliomas occur predominantly in females. Despite a marked tendency to recur, no malignant degeneration has ever been demonstrated, and only one mortality has ever been attributed directly to this lesion. The diagnosis of this entity is made by confirming the benign mesothelial nature of the cells lining the cysts with electron microscopy or immunohistochemical staining. No significant difference in the clinicopathologic presentation of cystic mesotheliomas in men and women is found.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/24. Localized benign biphasic mesothelioma of the pleura.A localized benign biphasic mesothelioma of the pleura is described. Immunohistochemically the epithelial-like cells contained vimentin intermediate filaments only, while electron microscopy revealed signs of true mesothelial differentiation demonstrating the hybrid nature of neoplastic mesothelial cells.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/24. An autopsy case of tuberous sclerosis associated with primary pericardial mesothelioma.tuberous sclerosis (Bourneville-Pringle phacomatosis) has been known to be associated with cardiac rhabdomyoma, but apparently never previously with primary pericardial mesothelioma. We present an autopsy case of this condition in a 59-year-old man, who had been diagnosed as having tuberous sclerosis in view of the presence of facial sebaceous adenoma, mental retardation, intracranial calcification, cerebral ventricular dilatation and renal tumor. During the clinical course, characterized by heart failure due to cardiac tamponade, cardiac sarcoma was diagnosed by imaging techniques. autopsy revealed biphasic-type primary pericardial mesothelioma. As to the tuberous sclerosis, atypical giant cells in the tubers of the cerebral cortex and the lateral ventricular wall were found, which were considered to be derived from neurons rather than glial cells on the basis of staining with Bodian, Holzer, and antibodies against NSE, GFA and S-100 protein. In old tubers protruding into the lateral ventricles, fibrous glias were present with dense calcospherite deposits, coinciding with the CT findings. The renal tumors were angiomyolipomas, which were present bilaterally and showed partially infiltrative growth, but seemed to have a benign nature because of the lack of metastasis and atypism of the leiomyocytes.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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