Alhumidi Ahmed, Alqahtani Abdulmalik
Professor and consultant of pathology, Department of pathology, College of medicine, King Saud University, Riyadh, Saudi Arabia.
Anatomic Pathology Resident, Department of pathology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
J Surg Case Rep. 2020 Jul 31;2020(7):rjaa203. doi: 10.1093/jscr/rjaa203. eCollection 2020 Jul.
It is extremely rare for malignant mesothelioma to present as gastrointestinal polyps. This case report documents the presentation of malignant mesothelioma in a 72-year-old as rectal bleeding and weight loss. Endoscopically, there were multiple gastric and colonic polyps. Histopathologically, there were atypical cells in the lamina propria with benign surface epithelium. The cells tested positive for cytokeratin, calretinin and D2-40 and negative for CD45, CD117, Ber-EP4 and CEA, confirming the diagnosis of metastatic mesothelioma. A computed tomography scan of the chest showed nodular thickening of the left lower pleura that was compatible with a diagnosis of primary pleural mesothelioma. We conclude that metastatic mesothelioma can sometimes present as gastrointestinal polyps.
恶性间皮瘤以胃肠道息肉形式出现极为罕见。本病例报告记录了一名72岁患者以直肠出血和体重减轻为表现的恶性间皮瘤。内镜检查发现胃和结肠有多个息肉。组织病理学检查显示固有层有非典型细胞，表面上皮为良性。这些细胞细胞角蛋白、钙视网膜蛋白和D2-40检测呈阳性，而CD45、CD117、Ber-EP4和癌胚抗原检测呈阴性，证实为转移性间皮瘤。胸部计算机断层扫描显示左下腹胸膜结节状增厚，符合原发性胸膜间皮瘤的诊断。我们得出结论，转移性间皮瘤有时可表现为胃肠道息肉。
