title: Primary localized malignant biphasic mesothelioma of the liver in a patient with asbestosis.
abstract: We report a case of primary localized malignant biphasic mesothelioma of the liver in a 66-year-old man associated with asbestosis. The tumor was detected as a hepatic nodule, 4 cm in diameter, in the right lobe (S8 segment) on CT scan. Histopathological examination demonstrated an intrahepatic tumor with central necrosis consisting of a papillary epithelioid pattern on the surface of the liver, microcystic (microglandular or adenomatoid) pattern mainly in the subcapsular area and sarcomatoid pattern intermingled with microcystic pattern in the major part of the hepatic nodular tumor. Tumor cells, especially of epithelioid type, showed distinct immunoreactivity for mesothelial markers (WT-1, calretinin, D2-40, CK5/6, mesothelin, thrombomodulin) and no immunoreactivity for epithelial (adenocarcinoma) markers (CEA, CD15, BerEP4, BG8, MOC31). P53 immunoreactivity was detected focally in papillary epithelioid tumor cells and extensively in microcystic and sarcomatoid components, suggesting that the papillary epithelioid mesothelioma arose on the surface of the liver, and tumor cells showing microcystic and sarcomatoid patterns invaded and grew into the liver. To date, this is the first case of primary localized malignant biphasic mesothelioma of the liver, since all three primary hepatic mesotheliomas reported so far were epithelioid type.
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Sasaki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Araki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yasui
authors.forename: Masaru
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Keita
authors.initials: K
authors.lastname: Itatsu
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nojima
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
mesh_terms: D000368:Aged; D001195:Asbestosis / Q000150:complications* / Q000473:pathology; D006801:Humans; D008107:Liver Diseases / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D009336:Necrosis; D011859:Radiography; D016896:Treatment Outcome