Cutaneous needle track seeding of mesothelioma diagnosed by fine needle aspiration cytology: a case report.
BACKGROUND
Diagnostic and therapeutic procedures for mesothelioma require surgical biopsy or the usage of different-sized needles. Thoracic wall involvement along the surgical or needle tracks has been reported.


METHODS
A 57-year-old woman who had suffered from non-Hodgkin's lymphoma complained of dyspnea and left pleural effusion. The patient had been treated with chemotherapy and radiotherapy and was in remission since then. Thoracentesis was performed using a 22-gauge needle; the cytologic diagnosis was malignant pleural mesothelioma. Within 2 weeks from thoracentesis, the patient complained of an erythematous swelling in her left chest wall, in the area of the needle track. Fine needle aspiration cytology (FNAC) of the swelling was performed using a 23-gauge needle; 2 smears and a cell block were prepared. Smears showed neoplastic cells in sheets and papillary configuration with the features of mesothelial lineage. Immunocytochemistry showed positivity for calretinin and vimentin. Cytologic slides of the former effusion showed an overlapping of the cytologic and immunocytochemical features. A diagnosis of chest wall involvement from mesothelioma was established and histologically confirmed.


CONCLUSIONS
Chest wall infiltration is a definite risk in the management of pleural mesothelioma, and FNAC is a useful procedure for a timely diagnosis of this ominous complication.
Department of Pathology, University of Naples "Federico II," Naples, Italy.
Jessica
J
Falleti
Marcella
M
Giordano
Immacolata
I
Cozzolino
Antonio
A
Vetrani
Amalia
A
De Renzo
Pio
P
Zeppa
D044963:Biopsy, Fine-Needle; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology*; D008875:Middle Aged; D012867:Skin / Q000473:pathology*; D035441:Thoracic Wall / Q000473:pathology*