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Pathology of

Pseudomesotheliomatous

Adenocarcinoma

Dr Sampurna Roy MD 

 

                                                                                                                      

 

 

'Pseudomesotheliomatous' carcinomas are uncommon pathologically heterogeneous tumours with poor prognosis.

The term 'pseudomesotheliomatous adenocarcinoma' was coined for these lesions by Harwood et al.

History of asbestos exposure is present one study. A smoking history is present in more than 70% cases.

By light microscopy and immunophenotype many of the tumours mimicked malignant mesothelioma.

Age: Usually occurs in elderly patients.

Clinical symptoms: Chest pain, dyspnea, cough, infiltrative pleural tumour. The symptoms are indistinguishable from those of malignant mesothelioma.

Macroscopic features: Thick, fleshy pleural plaques and masses that extend along the pleura surface and encase the lung.

Microscopic features:

 

Diagram of Pseudomesotheliomatous Adenocarcinoma

Pleura is infiltrated by nests and sheets of cells ; Tumour may focally form glandular structures or tubulo-papillary structures ;  Psammoma bodies may be present ; Isolated glands may be present in a fibrous stroma.

Histochemistry: PAS-positive diastase resistant mucin or intracytoplasmic vacuoles are often present in the glandular lumen.

Immunohistochemistry: CEA & low molecular weight cytokeratins are positive in almost all cases.

BER-EP4 and Leu M1 may also be positive.

Misdiagnosis of this tumour may have medico-legal implications in asbestos-related compensation claims.

 

Further reading:

Clinical comparison of diffuse malignant mesothelioma of the pleura and pseudomesotheliomatous carcinoma of the lung for each case.

Pseudomesotheliomatous carcinoma of the lung with histochemical and immunohistochemical study

Pseudomesotheliomatous carcinoma of the lung. A variant of peripheral lung cancer.

An autopsy case of pseudomesotheliomatous adenocarcinoma of the lung complicated with brain stem infarction due to nonbacterial thrombotic endocarditis].

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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