title: Well-differentiated papillary mesothelioma with invasion to the chest wall.
abstract: Well-differentiated papillary mesothelioma (WDPM) is an uncommon tumor with a papillary architecture, bland cytologic features, a tendency toward superficial spread without invasion, and good prognosis with prolonged survival. WDPM occurs primarily in the peritoneum of women, but also rarely in the pleura. We here report a case of 48-year-old woman who developed WDPM in the pleura with no history of asbestos exposure. Tumors were multifocal and widespread with a velvety appearance on the surface of parietal and visceral pleurae resected by extrapleural pneumonectomy (EPP). Tumors showed papillary structures with fibrovascular cores and lined by epithelioid cells. Immunohistochemically, these epithelioid tumor cells were positive for epithelial membrane antigen (EMA), a marker of malignant mesothelioma, with more than 50% positive for p53. Tumor cells microinvaded into subpleural parenchyma of the lung and minimally spread to adipose tissues of the mediastinal lesion. In addition, tumor cells invaded into the chest wall with a trabecular or glandular architecture. Based on these findings, this case is pathologically considered as WDPM of the pleura with malignant potential.
authors.affiliation: Department of Pathology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Torii
authors.forename: Masaki
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Terada
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kondo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fushimi
authors.forename: Kohki
authors.initials: K
authors.lastname: Shimazu
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Takeda
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Takuwa
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Okumura
authors.forename: Ayuko
authors.initials: A
authors.lastname: Sato
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fukuoka
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishigami
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Seiki
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Tsujimura
mesh_terms: D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D033162:Incidental Findings; D008654:Mesothelioma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000473:pathology; D010997:Pleural Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D011013:Pneumonectomy; D035441:Thoracic Wall / Q000473:pathology*
chemical_list: D018396:Mucin-1