Pseudomesotheliomatous carcinoma of the lung

Jelena Milivoje Vukovic; Goran Plavec; Slobodan Aćimović; Milena Jović; Marko Stojsavljević; Jovana Trimčev; Sanja Nikolajević; Vesna Skuletić; Olivera Lončarević; Vladan Živković; Lidija Zolotarevska; Snežana Cerović

doi:10.2298/VSP150811138V

Jelena Milivoje Vukovic Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
Goran Plavec Clinic for Pulmology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Slobodan Aćimović Clinic for Pulmology, Military Medical Academy, Belgrade, Serbia
Milena Jović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Marko Stojsavljević Clinic for Pulmology, Military Medical Academy, Belgrade, Serbia
Jovana Trimčev Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Sanja Nikolajević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Vesna Skuletić Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; †Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Olivera Lončarević Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
Vladan Živković Clinic for Pulmology Military Medical Academy, Belgrade, Serbia
Lidija Zolotarevska Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Snežana Cerović Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP150811138V

Keywords: lung neoplasms, adenocarcinoma, diagnosis, diagnosis differentiall, mesothelioma, malignant, prognosis, treatment outcome,

Abstract

Introduction. Pseudomesotheliomatous lung carcinoma is a special, rare entity characterized by large pleural growth and minor invasion of lung tissue. Clinically, radiologically, macroscopically and even histologically this tumor can be misdiagnosed as malignant pleural carcinoma. Case report. We represent a 64-year-old male patient, former smoker. Due to difficulties in the form of dry cough, feeling of discomfort and pain in the right hemithorax, fatigue, heavy breathing, sweating, fever up to 39.6°C the patient was treated as with combined antibiotic therapy (macrolides, cephalosporins and penicillin), but without improving of his condition. Chest radiography showed a shadow of pleural effusion by the height of the front end of the third right rib. Chest MSCT showed the extremely thickened pleura apically and to the posterior along the upper right lobe in addition to existence of massive pleural effusion. Subpleural condensation of parenchyma ranging about 30 mm was described in the upper right lobe. Cytological analysis of the pleural effusion showed the presence of malignant cells impossible to differentiate whether they were metastasis of adenocarcinoma or malignant pleural mesothelioma. By histochemical and immunohistohemical analyses of a pleural sample, pseudomesotheliomataus lung adenocarcinoma was diagnosed. Conclusion. Pseudomesotheliomataus carcinoma of the lungs can be a diagnostic problem. Its diagnosis is based on recognition of histopathological characteristics which enable its discernment from the epithelial variant of malignant pleural mesothelioma.

Author Biography

Jelena Milivoje Vukovic, Clinic for Pulmology Military Medical Academy, Belgrade, Serbia

Clinic for Pulmology

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