Abstract
Background. Pseudomesotheliomatous carcinoma of the lung (PMCL) is characterized by diffuse progression along visceral pleura, and has been confirmed histologically as a peripheral lung cancer. We report our experience of an autopsy case of PMCL. Case. A 71 year-old Japanese man presented with right chest pain and dyspnea in May 2003. A chest X ray film showed right massive pleural effusion. Adenocarcinoma was detected from pleural effusion and we diagnosed lung cancer (cT4N3M0 stage IIIB) by other detailed examinations. Although we attempted many different kinds of chemotherapies after insertion of a chest drainage tube in the right pleural space, he died 16 months after the diagnosis. At autopsy, no primary lesion was detected in the right lung, but the entire right lung was enclosed with thickened visceral pleura. Cancer tissue was detected along the pleura. Immunohistological examinations showed positive results for CEA and TTF-1, but negative for calretinin, so we finally diagnosed PMCL. Conclusion. We considered that not only cytological examination of pleural fluid but also histological examination is needed for a diagnosis of PMCL in a case of malignant pleural effusion when the primary lesion cannot be detected in the lungs.
