A case of localized malignant pleural mesothelioma with metastasis to supraclavicular lymph node

Abstract

A 55-year-old man had pain in his left shoulder and scapula. CT showed a tumor at the apex of the left lung, and PET-CT showed a high accumulation with SUVmax 9.74. CT-guided tumor biopsy revealed adenocarcinoma. He was diagnosed with left upper lobe lung cancer cT3N0M0 c-stage IIB. We performed a left upper lobectomy and resected the first to third ribs and dissected hilar and mediastinal and left supraclavicular lymph nodes. The size of the resected specimen was 6.0 × 5.0 × 3.6 cm. Pathological examination revealed that the center of the lesion was the parietal pleura that invaded the ribs and lungs. Tumor cells were arranged in trabecular, glandular, papillary, and microtubular growth patterns, partially with abundant stroma. Immunohistochemical staining revealed a localized malignant pleural mesothelioma of the epithelial type. Lymph node metastasis was found only in the left supraclavicular lymph node, and the diagnosis was pT4N2M0 pStage IIIB. He has been followed up for nine months since surgery without signs of recurrence.