A Case of Localized Type Malignant Mesothelioma with Difficulty in Preoperative Diagnosis.

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  • Ｌｏｃａｌｉｚｅｄ　ｔｙｐｅ　ｍａｌｉｇｎａｎｔ　ｍｅｓｏｔｈｅｌｉｏｍａの１例

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Abstract

Mesothelioma is originated from mesothelial cells. We experienced a case of malignant mesothelioma of the pleura showing localized form grossly. A 57-year-old man was admited to the hospital because of an elevated right hemidiaphragma on a chest X-ray film. Prospective possible diagnosis was diaphragmatic tumor, for which we planned a thoracoscopic resection. Intraoperative frozen section diagnosis was malignant tumor with invasion into the right lung and diaphragm, and a complete extirpation of the tumor with partial resections of the right lower lung and right diaphragm was performed. Microscopically. the tumor was diagnosed as malignant mesothelioma. Immunohistochemical stainings showed cytokeratin (+), vimentin (+), and CD34 (-). Thereafter the patient experienced recurrence twice and underwent a total removal of the tumor and chemotherapy. He is strictly followed in the clinic. Malignant mesothelioma presents difficulty in diagnosis in that immunohistochemical examination is helpful to differentiate it from other diseases. No effective therapies are available to treat the disease and its prognosisis is very poor. Definite differential diagnosis would be required in order to search for a new efficancious therapy.

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