Sussman J, Rosai J
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut 06510-8070.
Am J Surg Pathol. 1990 Sep;14(9):819-28.
We present six cases in which lymphadenopathy was the initial manifestation of malignant mesothelioma. In five cases, the primary tumor was located in the peritoneum; it was located in the pleura in the sixth. The involved lymph nodes were cervical in four cases, mediastinal in one, and inguinal in one. The morphologic, immunohistochemical, and ultrastructural features were typical of malignant epithelial mesothelioma. A review of the literature disclosed only one previously documented example of this phenomenon. When confronted with a lymph node involved by metastatic tumor, pathologists should be aware that malignant mesothelioma can present initially in the form of lymphadenopathy and include this possibility in the differential diagnosis.
我们报告了6例以淋巴结病为恶性间皮瘤初始表现的病例。其中5例原发肿瘤位于腹膜，第6例位于胸膜。受累淋巴结4例位于颈部，1例位于纵隔，1例位于腹股沟。形态学、免疫组化和超微结构特征均为典型的恶性上皮性间皮瘤。文献回顾仅发现1例此前记录的该现象实例。当面对有转移瘤累及的淋巴结时，病理学家应意识到恶性间皮瘤可最初表现为淋巴结病，并在鉴别诊断中考虑到这种可能性。
