Abstract

An analysis was conducted of the clinical, morphological, and immunohistochemical challenges in the diagnosis of malignant pleural mesothelioma, based on a rare clinical case. The basis for clinical consideration was a case of pleural mesothelioma in a 19-year-old patient. The clinical examination included physical examination, computed tomography (CT) of the chest, abdominal ultrasound, bronchoscopy, and general clinical laboratory tests. Treatment included surgical intervention consisting of subtotal resection of the pericardium with the tumor and left upper lobectomy, followed by adjuvant chemotherapy and radiotherapy. Therapeutic and diagnostic thoracotomy was performed due to suspicion of a soft-tissue sarcoma of the right mediastinum. The intraoperative macroscopic appearance was more consistent with pleural mesothelioma. The tumor was removed with resection of the pericardium and left upper lobectomy. Morphological examination of the surgical specimen showed a histological pattern consistent with epithelioid-type mesothelioma, G2, with infiltration into the lung lobe and part of the pericardium. Immunohistochemical examination of the paraffin-embedded tissue block using TTF-1 and CK7 antibodies demonstrated positive expression for both markers. 
 

Keywords

pleural mesothelioma clinicopathological diagnostic difficulties treatment

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