Tuberc Respir Dis.  2007 Apr;62(4):323-330. 10.4046/trd.2007.62.4.323.

Three Cases of Malignant Pleural Mesothelioma Misdiagnosed as Tuberculous Pleurisy

• Kim KU
• Kim JE
• Jo WS
• Lee JS
• Park HK
• Kim YS
• Lee MK
• I H
• Kim YD
• Lee CH

• KMID: 1970234
• DOI: http://doi.org/10.4046/trd.2007.62.4.323

Abstract

Malignant pleural mesothelioma(MPM) is an uncommon neoplasm which is originated from pleural mesothelial cells. The majority of MPM is associated with prior asbestos exposure. Patients often present with chest pain and dyspnea due to pleural effusion, which might be diagnosed with tuberculous pleurisy especially in Korea. MPM is well known for its poor prognosis with a median survival time of less than 12 months after diagnosis and no established standard treatment modality. We report 3 cases of MPM confirmed by video-assisted thoracoscopic biopsy first misdiagnosed as tuberculous pleurisy.

Keyword

Malignant pleural mesothelioma; Tuberculous pleurisy; Thoracoscopy

MeSH Terms

Asbestos
Biopsy
Chest Pain
Diagnosis
Dyspnea
Humans
Korea
Mesothelioma*
Pleural Effusion
Prognosis
Thoracoscopy
Tuberculosis, Pleural*
Asbestos

Figure

• 

  Figure 1 (A) Chest radiograph shows pleural effusion in the left hemithorax. (B) Contrast enhanced chest CT scan shows circumferential and nodular pleural thickening.

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  Figure 2 (A) Malignant epithelielial mesothelioma showing diffuse solid growth of atypical polygonal cells with abundant pale eosinophilic cytoplasm (H-E stain, ×400). (B) The tumor cells with strong nuclear and cytoplasmic immunoeactivity for calretinin (Streptavidin-biotin, ×400).

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  Figure 3 (A) Chest radiograph shows loculated pleural effusion with passive atelectasis in the right lung. (B) Contrast enhanced chest CT scan shows pleural effusion with pleural mass.

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  Figure 4 (A) Malignant epithelial mesothelioma showing solid nests of atypical polygonal mesothelial cells (H-E stain, ×400). (B) The tumor cells with strong nuclear and cytoplasmic immunoreactivity for calretinin (Streptavidin-biotin, ×400).

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  Figure 5 (A) Chest radiograph shows pleural effusion in the right lung. (B) Contrast enhanced chest CT scan shows pleural effusion with metastatic nodules on chest wall.

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  Figure 6 (A) Malignant pleural mesothelioma showing the same histologic featue as cases 1 and 2 (H-E stain, ×400). (B) The infiltrating tumor cells with strong cytoplasmic immunoreactivity for high molecular weight cytokeratin (Streptavidin-biotin, ×400).

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