title: Mesothelial Inclusions in Pelvic Lymph Nodes Initially Diagnosed as Metastatic Prostate Cancer; the Utility of Second Opinions and Genomic Testing in the Setting of Unexpected Results.
abstract: Benign mesothelial inclusions in pelvic lymph nodes may be mistaken for metastatic disease in the setting of pelvic malignancy. In this case-report a patient with Low-Risk prostate cancer (confirmed by biopsy and genomic testing) underwent radical prostatectomy with pelvic lymph node dissection. The initial pathological diagnosis was organ-confined Gleason 3 + 3 = 6 cancer with metastasis to a pelvic lymph node. Upon review of the pathological specimen and immunohistochemical staining the lymph node tissue concerning for metastatic disease was recharacterized as mesothelial in origin. This case illustrates the importance of second opinions and immunohistochemistry for unexpected or unusual pathological findings.
authors.affiliation: Wichita Urology, 2626 N Webb Rd., Wichita, KS, 67226, USA.
authors.forename: Fadi
authors.initials: F
authors.lastname: Joudi
authors.affiliation: Genomic Health Inc, 101 Galveston Dr., Redwood City, CA, 94063, USA.
authors.forename: Bela S
authors.initials: BS
authors.lastname: Denes
authors.affiliation: Genomic Health Inc, 101 Galveston Dr., Redwood City, CA, 94063, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Mies
authors.affiliation: Genomic Health Inc, 101 Galveston Dr., Redwood City, CA, 94063, USA.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Shindel
keywords: Genomics; Lymph nodes; Mesothelial inclusions; Metastasis; Prostate cancer; Risk-stratification