Presentation
Dyspnoea and chest pain on the left side.
Patient Data
Marked circumferential nodular pleural thickening with numerous internal calcifications in the left hemithorax, which encases the left lung, including extension onto the mediastinal and parietal pleura. The left lung demonstrates volume loss and is obliterated by tumoural masses and there is a mild deviation of the mediastinal structures toward the right side.
No associated pleural effusion.
The right pleural space is clear.
No pulmonary nodule or mass lesion.
Case Discussion
Imaging features are consistent with malignant pleural mesothelioma and subsequently confirmed on histology.
Pathological report:
Microscopic description:
Fragments of fibroconnective tissues are seen revealing focal aggregation of mesothelial cells at the surface of the specimen. There are also scattered foci of infiltrations of connective tissue by sheets of epithelial cells few of them have atypical angulated large nuclei.
Pathological diagnosis:
Atypical mesothelial proliferations.
IHC report:
The neoplastic cells express immunoreactivity as below:
Positive for
Calretinin (scattered)
CK 5/6 (scattered)
CKAE1/AE3 (scant)
CK7 (scant)
Ki 67 (30%)
Negative for
TTF1
Diagnosis:
IHC expression is consistent with malignant mesothelioma.
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