An Autopsy Case of Diffuse Pleural Mesothelioma Associated with Pulmonary Asbestosis : Light and Electron Microscopic Study
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Presented in this paper is an autopsy case of diffuse pleural mesothelioma with pulmonary. asbestosis of a 65-year-old Japanese male who had been exposed to asbestos fiber for 27 years. The histological examination at autopsy showed a tubullo-papillary pattern with fibrosarcomatous components consisting mainly of spindle cells. An electron microscopic study of the spindle-shaped cells showed both epithelial differentiation in various degrees and fibroblastic cells. The findings support the concept of a mesothelial origin for diffuse mesothelloma and a bipotentiality of mesothelial cells. According to the autopsy series of the Japanese Pathological Society, the incidences of mesothelioma was O.097% (124 cases) of which pleural mesothelioma were O.066% (83 cases) of 126, 535 autopsies in Japan from 1974 through 1978. None of them was associated with pulmonary asbestosis. The literature review reveals that a case of mesothelioma associated with asbestosis is rare in Japan and as far as we know only four cases were reported up until 1979.(Received 17 November 1981)造船所でボイラー製造に従事し, 27年間, 石綿粉塵を吸入していた65才男性に見られた肺石綿症合併の瀰漫性胸膜中皮腫剖検例を報告した. 腫瘍は, 右胸膜に原発し, 両側腎臓, 右副腎, 傍胃リンパ節などに転移し, 末期には, 上大静脈症候群をきたして, 発症13ケ月後に, 突然死した. 組織学的には二相性で線維肉腫様の紡錘型細胞を混じえ, またこれらと種々の程度に移行する腺管状, 乳頭状増殖を示していた. 電顕的には紡錘型細胞にも, 上皮的性格を示すものが見られた。日本剖検輯報によると過去5年間(1974-1978年)の全剖検例126,535例中, 124例(0.097%)が中皮腫で死亡しており, 部位別には, 胸膜83例, 腹膜27例, 心嚢12例, 腸間膜1例, 小腸漿膜1例であった. これらは, いずれも石綿症を伴っていなかった. 一方, 同期間中の肺石綿症剖検例は7例で, そのうち3例に肺癌, 1例に喉頭癌を合併していた. 文献的には本邦における石綿症合併の中皮腫は4例に過ぎなかった.
- 1982-03-01
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