title: Localized malignant mesothelioma of the epithelial type occurring as a primary hepatic neoplasm: a case report with review of the literature.
abstract: We report a localized malignant mesothelioma of the epithelial type, occurring as a primary hepatic neoplasm in a 64-year-old male. He was found to have a mass located in the right lobe of the liver. Surgery was carried out with resection of the mass from the right hepatic lobe, with partial resection of the diaphragm. Grossly, an ill-defined tumor was present in the hepatic parenchyma. Histologically, the tumor displayed a predominant tubular pattern of growth with a desmoplastic stroma. The tubules were lined by a single layer of cuboidal or flattened cells with pleomorphic vesicular nuclei. A hyaluronidase-digestible, mucin-like substance was demonstrated in the lumen and tumor cytoplasm. The tumor cells were immunohistochemically positive for calretinin, HBME-1, cytokeratin, i.e. AE1/AE3 and CAM 5.2, but negative for carcinoembryonic antigen, CD 34 and Leu M1. Moreover, the tumor cells showed nuclear accumulation of the p53 oncopotein and reacted frequently with Ki-67 antibody. These findings support the concept that malignant mesothelioma of the epithelial type may occur at extrapleural sites. To the best of our knowledge, this is the first reported case of localized malignant primary mesothelioma arising in the liver.
authors.affiliation: Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Tochigi, Japan. imura@dokkyomed.ac.jp
authors.forename: Johji
authors.initials: J
authors.lastname: Imura
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Takeda
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tomita
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
mesh_terms: D015415:Biomarkers / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D064032:Calbindin 2; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008654:Mesothelioma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D064030:S100 Calcium Binding Protein G / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D000951:Antigens, Neoplasm
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D064032:Calbindin 2; D007633:Keratins; D019394:Ki-67 Antigen; D064030:S100 Calcium Binding Protein G; D016159:Tumor Suppressor Protein p53; C576764:CALB2 protein, human; C400901:CAM 5.2 antigen; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm