Abstract
We report a case of localized malignant pleural mesothelioma in a 69-year-old man who had a history of smoking and no history of asbestos exposure. An abnormal nodule in the left lung field was noted on a plain chest X-ray film. Chest CT showed an intrathoracic nodule on the left back pleura. PET-CT showed a hot lesion on the left pleural nodule, suggesting that the nodule was malignant. Therefore, video-assisted thoracic surgery was performed. On thoracoscopy, the nodule was found to arise from the parietal pleura and to adhere to the upper lobe of the lung ; there was no diffuse pleural spread. Since it was difficult to make a diagnosis based on intraoperative pathology the tumor and the pleura with the part of the upper lung were resected. On histopathology, tumor cell atypia, polymorphism, and mitosis were noted. Cytokeratin, EMA, and vimentin were positive, and CEA and CD34 were negative on immunohistchemical staining. Based on these findings, localized malignant pleural mesothelioma was diagnosed. As there was microscopic invasion of the pleural stump, postoperative radiotherapy was instituted. No signs of recurrence have been seen during 5 years of follow-up.
