年轻男性腹膜恶性间皮瘤转移至淋巴结——病例报告
Peritoneal Malignant Mesothelioma Metastasizing to Lymph Node in Young Male-a Case Report.
作者信息
Singh Amanpreet, Bansal Cherry, Singla Disha, More Sarika, Chabhra Shivani, Bashir Shazia
机构信息
Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab India.
Department of Pathology, Dr SS Tantia Medical College, Hospital, & Research Center, Sri Ganganagar, Rajasthan India.
出版信息
Indian J Surg Oncol. 2024 Mar;15(1):145-148. doi: 10.1007/s13193-023-01838-1. Epub 2023 Oct 19.
Peritoneal malignant mesothelioma is an uncommon neoplasm with a poor prognosis. We hereby report a case of a 20-year-old male, first diagnosed on biopsy with axillary lymph node metastasis. He presented with abdominal pain and axillary lymphadenopathy, with no history of asbestos exposure. CECT showed peritoneal thickening and ascites. Ascitic fluid cytology showed reactive morphology. The diagnosis of metastatic deposits of malignant mesothelioma was made on histopathology and confirmed by immunohistochemistry. Tumor cells were immune-reactive for CK 5/6, calretinin, D2-40, and WT1 and negative for TTF1, CK 20, and CD 3. This case report has two important highlights-(i) unusual presentation with axillary lymph node metastasis leading to diagnostic dilemma in a young male with no asbestos exposure history and (ii) confirmatory diagnostic role of IHC in Peritoneal malignant mesothelioma.
腹膜恶性间皮瘤是一种罕见的肿瘤，预后较差。我们在此报告一例20岁男性病例，首次经活检诊断为伴有腋窝淋巴结转移。他表现为腹痛和腋窝淋巴结肿大，无石棉接触史。增强CT显示腹膜增厚和腹水。腹水细胞学检查显示为反应性形态。通过组织病理学诊断为恶性间皮瘤转移灶，并经免疫组化证实。肿瘤细胞对细胞角蛋白5/6、钙视网膜蛋白、D2-40和WT1呈免疫反应，对甲状腺转录因子1、细胞角蛋白20和CD 3呈阴性。本病例报告有两个重要亮点——（i）在一名无石棉接触史的年轻男性中，出现不寻常的腋窝淋巴结转移表现，导致诊断困境；（ii）免疫组化在腹膜恶性间皮瘤诊断中的确诊作用。
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