Article

Desmoplastic malignant mesothelioma: two cases and a literature review.

Second Department of Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Medical Electron Microscopy 10/2003; 36(3):173-8. DOI: 10.1007/s00795-003-0217-0
Source: PubMed

ABSTRACT We present two cases of desmoplastic malignant mesothelioma (DMM) with pathological, immunohistochemical, and ultrastructural features. Each patient showed rapid progress and died within 1 year from appearance of the initial symptoms. Macroscopically, both showed a thickened pleura replaced by a tumor that encased the lung. Microscopic results of each showed that the tumors consisted of a dense fibrous area, with mild nuclear irregularities and hyperchromatism. In case 1, the tumor had invaded the diaphragm, chest wall, and cardiac sac; the mass in case 2 invaded the lung and diaphragm, and distal metastases were seen in the thoracic vertebrae, meninges, and liver. Ultrastructural findings in case 1 showed a few short blunt microvilli on the cell surfaces. DMM is occasionally difficult to distinguish from fibrous pleurisy and solitary fibrous tumor. Immunohistochemical examinations of the present cases showed the expression of cytokeratin and vimentin, and focal positive stainings of antihuman mesothelial cell antibody (HBME-1) in both, whereas CD34 and bcl2 were negative. Solitary fibrous tumor was excluded. Therefore, pathological, ultrastructural, and immunohistochemical findings led us a diagnosis of DMM in each case. The Ki-67 labeling index (Ki-67 LI) of cases 1 and 2 was 25.5 and 15.5, respectively, both high, which suggested malignancy. Widespread immunohistological panels of malignant mesothelioma were not evaluated; Immunohistological markers commonly used for the diagnosis of malignant mesothelioma were not evaluated; however, the high ki-67 LI results and positive HBME-1 staining were helpful factors for the diagnoses of DMM.

0 Bookmarks
 · 
79 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Desmoplastic mesothelioma is unusual variant of malignant mesothelioma. The diagnosis of desmoplastic mesothelioma represents one of the most difficult exercises in pleural pathology (with poor interobservers agreement) because of their abundant collagen with relatively low cellularity. The clinical course is often rapid with visceral metastases. Bony metastases have only rarely been noted. We report our case of desmoplastic mesothelioma with vertebral metastases. Our focus is to distinguish this entity from fibrous pleurisy and localized fibrous tumors, to explain histological and immunohistochemical features with review of the literature.
    Revue de Pneumologie Clinique 02/2012; 68(1):23-6. · 0.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Desmoplastic mesothelioma (DMM) is a rare and highly lethal subtype of diffuse malignant mesothelioma and is often difficult to distinguish from reactive pleural fibrosis. The term "desmoplastic" refers to the growth of fibrous or connective tissue. We report the clinical, radiological, and pathological features of a primary DMM of the pericardium and a short review of the literature. A 72-year-old man was admitted presenting shortness of breath, cough, and asthenia. Computed tomography scan showed thickenings and effusions both in the pleura and in the pericardium. Histopathological diagnosis was performed by surgical pericardial biopsy and confirmed by autopsy. The patient had a history of asbestos exposure. Primary mesothelioma of the pericardium is a rare tumor occurring in the fourth to seventh decades with nonspecific symptoms and a rapid clinical course. The diagnosis is difficult and often needing a surgical pericardial biopsy. The prognosis is poor although newer antiblastic drugs seem to prolong survival times.
    Lung India 07/2011; 28(3):219-21.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: : A 42-year-old male presented right upper abdomen pain for more than 6 days, which misdiagnose calculus of intrahepatic duct and acute cholecystitis. An approximately 1.5cmx1.0cmx1.0 cm nodule was found and resected in left lateral lobe of hepatic. Pathological examination showed spindle cell and fibroblast -like cells within the collagenous stroma. Immunohistochemically, these spindle tumor cells showed diffuse Vim and Bcl-2 positive reactivity, but S-100 protein and HMB45 were negative. The post-operative course was uneventful. Solitary fibrous tumors of the liver, although rare, should be differentiated from mesenchymal lesions of the liver.Virtual slide: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4214341041091088.
    Diagnostic Pathology 12/2013; 8(1):195. · 2.41 Impact Factor