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Vol.58 No.1 contents | Japanese/English |
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- Case Report -
An Autopsy Case of Desmoplastic Malignant Mesothelioma with a Transbronchial Biopsy
Hiroyuki Honda1,2, Yuji Mori1, Tatsuru Ishikawa1, Takahiro Ono1, Hisashi Nakata1, Hiroki Takahashi21Department of Respiratory Medicine, Hokkaido Goryoukaku Hospital, Japan, 2Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Japan
Background. Bronchoscopy is rarely used in the diagnosis of malignant pleural mesothelioma. Case. A man in his 70s visited our hospital with dyspnea on exertion, right back pain, and a fever. Chest computed tomography showed right pleural effusion, collapse of the right-middle and lower lobes, circumferential thickening of the right parietal pleura, and bone destruction of the ninth rib, corresponding to the region of pain. Pleural effusion cytology showed no malignant cells, and no histopathological diagnosis could be obtained after a percutaneous pleural biopsy. However, because pleural lesions invading the lung parenchyma were suspected, a transbronchial biopsy was performed, resulting in the diagnosis of malignant pleural mesothelioma. Specifically, the specimen showed collagen fibers with atypical spindle cells; therefore, desmoplastic malignant mesothelioma (DMM) was suspected. A pathological autopsy confirmed a diagnosis of DMM, with tumors invading the lung parenchyma and extensive metastasis out of the pleura. Conclusion. Malignant pleural mesothelioma has different histological types that can be diagnosed through a variety of imaging findings. If pleural lesions invading the lung parenchyma are suspected, bronchoscopy with a transbronchial biopsy should be considered.
key words: Malignant pleural mesothelioma, Desmoplastic malignant mesothelioma, Transbronchial biopsy
Received: July 7, 2017
Accepted: November 9, 2017
JJLC 58 (1): 29-34, 2018
