Concomitant malignant mesothelioma of the pleura, peritoneum, and tunica vaginalis testis

✍ Scribed by Valeria Ascoli; Francesco Facciolo; Siavash Rahimi; Caterina Carnovale Scalzo; Francesco Nardi

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 830 KB
• Volume: 14
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/(sici)1097-0339(199604)14:3<243::aid-dc9>3.0.co;2-i

✦ Synopsis

We describe the cytohistological, immunohistochemical and ultrastructural findings in a 55-yr-old-man with history of asbestos exposure and diffuse malignant mesothelioma (DMM) of the pleura, peritoneum, and tunica vaginalis presenting with chest pain and scrota1 swelling. Pleural fine-needle aspiration (FNA) revealed mesenchymal elements and spindle-shaped epitheliallike cells, while biopsy showed pure sarcomatous tumor invading lung parenchyma. In both samples tumor cells coexpressed cytokeratin and vimentin. Peritoneal and hydrocele effusions contained aggregates of malignant mesothelial cells. Electron microscopy showed intermediate filaments, rare desmosomes and sparse microvilli. Morphologicaljindings were consistent with a DMM, with a biphasic pattern in the pleura and an epithelial one in the peritoneum and tunica vaginalis.

Although the possibility of a multicentric origin cannot be ruled out, clinical chronologic sequence suggests that the pleura was the primary involved site, followed by spread to peritoneum and tunica vaginalis.