Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo Prefecture, 650-0017, Japan.
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo Prefecture, 650-0017, Japan.
Virchows Arch. 2020 Mar;476(3):469-473. doi: 10.1007/s00428-019-02674-x. Epub 2019 Oct 30.
Malignant pleural mesothelioma (MPM), associated with unfavorable outcomes, is closely associated with asbestos exposure. Early detection and treatment are critical to prolong survival of patients with MPM because of the rapid progression and resistance to treatment. The recently defined malignant mesothelioma in situ (MIS) has been gaining increasing attention with advances in genome-based methods including fluorescence in situ hybridization (FISH) as well as immunohistochemistry. We herein report the case of a MIS in a 73-year-old male with a history of asbestos exposure presenting with massive pleural effusion in the right thoracic cavity. Video-assisted thoracoscopic surgery with pleural biopsy of the right side revealed a single layer of atypical mesothelial cells without invasive lesions by hematoxylin and eosin staining. However, these mesothelial cells exhibited a loss of methylthioadenosine phosphorylase (MTAP) by immunohistochemistry and homozygous deletion of CDKN2A (p16) by FISH, leading to the diagnosis of MIS.
恶性胸膜间皮瘤（MPM）与不良预后密切相关，与石棉暴露密切相关。由于进展迅速且对治疗有抵抗力，早期发现和治疗对于延长 MPM 患者的生存至关重要。最近定义的恶性间皮瘤原位（MIS）随着基于基因组的方法的进步，包括荧光原位杂交（FISH）和免疫组织化学，受到越来越多的关注。本文报告了一例 73 岁男性病例，该男性有石棉暴露史，表现为右侧胸腔大量胸腔积液。右侧胸腔镜辅助手术和胸膜活检显示单层非典型间皮细胞，苏木精和伊红染色未见浸润性病变。然而，这些间皮细胞通过免疫组织化学显示出甲基硫代腺苷磷酸酶（MTAP）缺失，通过 FISH 显示出 CDKN2A（p16）的纯合缺失，导致 MIS 的诊断。
