[Mesothelioma and mesothelial hyperplasia].

Twenty cases of pleural mesothelioma (2 localized and 18 diffuse malignant pleural mesothelioma), 6 cases of diffuse malignant peritoneal mesothelioma and 1 case of mesothelial hyperplasia were reported. The prominent clinical manifestations of malignant mesothelioma was serosal effusion. The exudate was bloody, mucinous and of high specific gravity. It contained numerous mesothelial cells. The diagnosis is difficult because mesothelial hyperplasia and other malignant tumors may mimic mesothelioma in some clinical aspects. Roentgenography, CT scan, cytology of serosal fluid and biopsy world help to establish the diagnosis of mesothelioma. Immunohistochemical features of 4 cases of mesothelioma is negative immunostaining for carcino embryonic antigen (CEA) and positive for keratin antigen. In one case ultrastructural examination showed characteristic features of epithelial mesothelioma cells. The average survival period in case of chemotherapy and/or surgical intervention in patients of this series was 31.3 months. Mesothelial hyperplasia has rather good prognosis; but the strategy of therapy may be conservative.