先天緑内障患者に発生したα-smoothmuscleactin陽性びまん性胸膜悪性中皮腫の1例

概要

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An autopsy case of diffuse malignant mesothelioma, once diagnosed asleiomyosarcoma based on the immunohistochemical results of open pleural biopsy, isdescribed. A 54-year-old blind man was admitted to our hospital complaining of leftpleural effusion. Chest CT examination revealed a mass of anterior mediastinum and leftpleura. CT-guided pleuro-mediastinal biopsy showed hyalinized fibrotic tissue withspindle cells. Open pleural biopsy performed in another hospital showed spindle celltumor with hypercellularity and frequent mitosis. Immunohistochemically cytokeratin5/6was negatlve, vlmentin was posltlve, and α-smooth muscle actin (α-SMA) was positive.Two months and a half after the biopsy the patient died. At autopsy the tumor wasfound to spread over the left pleura, making a hard nodule in the upper mediastinum andprotruding from the anterior chest wall. Microscopically cellular element was dominant inthe pleura and collagenous tissue was abundant in the mediastinum. Tumor cells werepositive for broad spectrum keratin and vimentin, compatible with diffuse malignantmesothelioma. Discussion is added concerning histological diagnosis of this case, α-SMAexpression of mesothelioma cells, and the relationship between congenital glaucoma andmesothelioma.
奈良医学会の論文
2003-08-30