Sakuma N, Kamei T, Unoki T, Okamura H, Ishihara T
Department of Pathology, Yamaguchi Central Hospital, Hofu, Japan.
Pathol Int. 1997 Jan;47(1):64-7. doi: 10.1111/j.1440-1827.1997.tb04436.x.
A report is presented of an autopsy case of a 71-year-old Japanese man with a diffuse malignant epithelial mesothelioma of the pericardium with massive pericardial effusion and a thickened pericardium. He had no history of exposure to asbestos. He suffered severe heart failure and later died. Autopsy revealed that the tumor had developed over the pericardium. Microscopically, the tumor cells were arranged in an epithelial form, and histochemically, the cytoplasm of these cells contained glycogen and hyaluronic acid. The tumor tissue showed immunohistochemical positivity for cytokeratin, epithelial membrane antigen, vimentin, cancer antigen 125, thrombomodulin, mesothelial antigen, muscle actin and human milk fat globule. In contrast, all the tumor cells were negative for human carcinoembryonic antigen and epithelial antigen. Ultrastructurally, the tumor cells had long, thin microvilli, abundant intermediate filaments, intracytoplasmic lumina and long desmosomes. It is considered that the patient had a typical malignant epithelial mesothelioma of the pericardium.
本文报告了一例71岁日本男性的尸检病例，该患者患有弥漫性恶性心包上皮间皮瘤，伴有大量心包积液和心包增厚。他没有接触石棉的病史。他患有严重心力衰竭，最终死亡。尸检显示肿瘤在心包上生长。显微镜下，肿瘤细胞呈上皮样排列，组织化学检查显示这些细胞的细胞质含有糖原和透明质酸。肿瘤组织对细胞角蛋白、上皮膜抗原、波形蛋白、癌抗原125、血栓调节蛋白、间皮抗原、肌肉肌动蛋白和人乳脂肪球呈免疫组化阳性。相比之下，所有肿瘤细胞对人癌胚抗原和上皮抗原均为阴性。超微结构上，肿瘤细胞有长而细的微绒毛、丰富的中间丝、胞质内管腔和长桥粒。认为该患者患有典型的心包恶性上皮间皮瘤。
