Okamoto H, Matsuno Y, Noguchi M, Morinaga S, Fujioka Y, Tsuchiya R, Tamura T, Shimosato Y
Pathology Division, National Cancer Center Research Institute, Japan.
Am J Surg Pathol. 1992 Oct;16(10):969-74. doi: 10.1097/00000478-199210000-00007.
Two cases of malignant pleural tumor producing human chorionic gonadotropin, one confirmed at surgery and autopsy and the other by biopsy, are reported. Both of the patients had bilateral gynecomastia with high levels of serum human chorionic gonadotropin. The first patient underwent panpleuropneumonectomy because of diffuse malignant pleural tumor, but died five months later due to recurrent disease. The histological diagnosis was diffuse, malignant, monophasic mesothelioma of the epithelial type. Immunostaining for alpha-, beta-human chorionic gonadotropin and human placental lactogen was positive in syncytiotrophoblast-like cells. The second patient had diffuse pleural tumor with massive effusion. A pleural biopsy specimen showed diffuse proliferation of epithelioid large cells. Immunostaining for alpha, beta-human chorionic gonadotropin and human placental lactogen was positive in mono- and multinucleated bizarre giant cells mimicking trophoblasts. A diagnosis of malignant mesothelioma with trophoblastic differentiation seemed most likely in both cases in view of the clinical and pathological findings. In both cases, results of mucin histochemistry and various immunohistochemical stains for antigens or with antibodies were consistent with diagnosis of mesothelioma except in a few cells in the choriocarcinomatous portion. This may be the first report describing human chorionic gonadotropin-producing malignant mesotheliomas of the pleura.
报告了两例产生人绒毛膜促性腺激素的恶性胸膜肿瘤病例，一例经手术和尸检确诊，另一例经活检确诊。两名患者均有双侧乳腺增生且血清人绒毛膜促性腺激素水平升高。首例患者因弥漫性恶性胸膜肿瘤接受了全胸膜肺切除术，但5个月后因疾病复发死亡。组织学诊断为上皮型弥漫性恶性单相间皮瘤。合体滋养层样细胞中α、β - 人绒毛膜促性腺激素和人胎盘催乳素免疫染色呈阳性。第二例患者有弥漫性胸膜肿瘤伴大量胸腔积液。胸膜活检标本显示上皮样大细胞弥漫性增生。模仿滋养层细胞的单核和多核奇异巨细胞中α、β - 人绒毛膜促性腺激素和人胎盘催乳素免疫染色呈阳性。鉴于临床和病理表现，两例病例最可能的诊断均为具有滋养层分化的恶性间皮瘤。在两例病例中，除了绒毛膜癌部分的少数细胞外，黏液组织化学结果以及针对抗原或抗体的各种免疫组织化学染色结果均与间皮瘤的诊断一致。这可能是首例描述产生人绒毛膜促性腺激素的胸膜恶性间皮瘤的报告。
