Ascoli V, Facciolo F, Rahimi S, Scalzo C C, Nardi F
Dipartimento di Medicina Sperimentale, Università La Sapienza, Rome, Italy.
Diagn Cytopathol. 1996 May;14(3):243-8. doi: 10.1002/(SICI)1097-0339(199604)14:3<243::AID-DC9>3.0.CO;2-I.
We describe the cytohistological, immunohistochemical and ultrastructural findings in a 55-yr-old-man with history of asbestos exposure and diffuse malignant mesothelioma (DMM) of the pleura, peritoneum, and tunica vaginalis presenting with chest pain and scrotal swelling. Pleural fine-needle aspiration (FNA) revealed mesenchymal elements and spindle-shaped epithelial-like cells, while biopsy showed pure sarcomatous tumor invading lung parenchymal. In both samples tumor cells coexpressed cytokeratin and vimentin. Peritoneal and hydrocele effusions contained aggregates of malignant mesothelial cells. Electron microscopy showed intermediate filaments, rare desmosomes and sparse microvilli. Morphological findings were consistent with a DMM, with a biphasic pattern in the pleura and an epithelial one in the peritoneum and tunica vaginalis. Although the possibility of a multicentric origin cannot be ruled out, clinical chronologic sequence suggests that the pleura was the primary involved site, followed by spread to peritoneum and tunica vaginalis.
我们描述了一名55岁男性的细胞组织学、免疫组织化学和超微结构检查结果，该患者有石棉接触史，患有胸膜、腹膜和鞘膜弥漫性恶性间皮瘤（DMM），表现为胸痛和阴囊肿胀。胸膜细针穿刺活检（FNA）显示间充质成分和梭形上皮样细胞，而活检显示纯肉瘤样肿瘤侵犯肺实质。在两个样本中，肿瘤细胞均共表达细胞角蛋白和波形蛋白。腹腔积液和鞘膜积液中含有恶性间皮细胞聚集体。电子显微镜检查显示有中间丝、罕见的桥粒和稀疏的微绒毛。形态学检查结果与DMM一致，胸膜表现为双相模式，腹膜和鞘膜表现为上皮样模式。尽管不能排除多中心起源的可能性，但临床时间顺序表明胸膜是主要受累部位，随后扩散至腹膜和鞘膜。
