Author/Authors :
Ideguchi, Reiko Department of Radiology - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Akashi, Saori Department of Radiology - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Shindo, Michiko Department of Radiology - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Minami, Kazunori Department of Radiology - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Fukuda, Toshio Department of Radiology - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Ashizawa, Kazuto Department of Clinical Oncology - Nagasaki University Graduate School of Biomedical Sciences - Nagasaki, Japan , Irie, Junji Department of Pathology - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Fukuda, Minoru Department of Internal Medicine - Nagasaki Harbor Medical Center City Hospital - Nagasaki, Japan , Uetani, Masataka Department of Radiological Sciences - Nagasaki University Graduate School of Biomedical Sciences - Nagasaki, Japan
Abstract :
We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-oldman and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showedpleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis ofepithelioid malignant mesothelioma. They received chemotherapy,but the treatment was only palliative. The chest CT assessmentsduring admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass withbronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangiticspread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy wasperformed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor.Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor.Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis,especially in patients with pleural lesions
