Maeda Ryo, Isowa N, Kawasaki Y, Tokuyasu H, Itakura A, Miura H, Onuma H
Division of Thoracic Surgery, Matsue Red Cross Hospital, Matsue, Japan.
Kyobu Geka. 2007 Jul;60(7):555-8.
Pseudomesotheliomatous carcinoma is the lung cancer with marked pleural extension resembling malignant pleural mesothelioma on diagnostic imaging. We report a rare case of pseudomesotheliomatous carcinoma of the lung in a 72-year-old man. The patient had complained of dyspnea and a chest roentgenogram showed right pleural effusion. Computed tomography (CT) of the chest revealed diffuse irregular pleural thickening, which mimicked pleural malignant mesothelioma. Pleural tissue sampling was performed to obtain definitive diagnosis by video-assisted thoracoscopic surgery. At the operation. the tumor was found to have a spread along the pleural surface and primary lesion was not detected in the right lung parenchyma. Immunohistochemically, the tumor was positive for carcinoembryonic antigen (CEA), but negative for calretinin, thrombomodulin, and pulmonary surfactant apoprotein. Final diagnosis was adenocarcinoma of the lung.
假间皮瘤样癌是一种在诊断影像学上具有明显胸膜侵犯、类似恶性胸膜间皮瘤的肺癌。我们报告一例72岁男性罕见的肺假间皮瘤样癌病例。患者主诉呼吸困难,胸部X线片显示右侧胸腔积液。胸部计算机断层扫描(CT)显示弥漫性不规则胸膜增厚,类似胸膜恶性间皮瘤。通过电视辅助胸腔镜手术进行胸膜组织采样以获得明确诊断。手术中,发现肿瘤沿胸膜表面扩散,右肺实质未检测到原发灶。免疫组织化学检查显示,肿瘤癌胚抗原(CEA)阳性,但钙视网膜蛋白、血栓调节蛋白和肺表面活性物质载脂蛋白阴性。最终诊断为肺腺癌。