術前診断が困難であった横隔膜原発良性限局性線維性胸膜中皮腫の１例

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  • A Case of Benign Localized Fibrous Mesothelioma of the Diaphragm, Which was Difficult to Diagnose Preopelably.

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A 47-year-old woman was referred to our hospital with an elevated right hemidiaphragm on a chest X-ray. Preoperative angiography showed a huge tumor whth feeding arteries branching off the right and left hepatic and right subphrenic arteries, and surgery was performed whth a preoperative diagnosis of subdiaphragmatic liver tumor. The intraoperative diagnosis was diaphragmatic tumor with liver compression and right lung invasion, and complete extirpation of the tumor with partial resection of the right diaphragm and right lower lung was performed. The tumor was 14-10 cm in size and weighed 1, 300 g. Microscopically, fibroblastic tissue was tightly arranged with no evidence of dysplasia. Immunohistochemical staining showed keratin (-), epithelial membrane marker (-), S-100 (-), and vimentin (+), and the final pathological diagnosis was benign localized fibrous mesothelioma of the diaphragm. The patient's postoperative course has been good, with no evidence of recurrence after 12 months.

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