Tuberc Respir Dis.  2014 Jun;76(6):284-288.

p53 Expression in a Malignant Mesothelioma Patient during Seven-Year Follow-up

• Koo SM
• Uh ST
• Kim DW
• Kim KU
• Kim YK

Abstract

Malignant mesothelioma (MM) is the aggressive tumor of serosal surfaces. There are crude pathogenetic results regarding the biology of MM. Coordinated upregulations of p53 gene expression are shown in malignancies. We believed that there are changes in the p53 expression with transformation from reactive hyperplasia to MM. A 65-year-old male was admitted the hospital because of left pleuritic chest pains in 2004. Chest computed tomography (CT) results showed left pleural effusions with loculation and pleural thickening. Pathologic findings revealed reactive mesothelial hyperplasia. In 2008, the patient again felt left pleuritic chest pains. Chest CT showed progressive thickening of the left pleura. Pathologic diagnosis was atypical mesothelial hyperplasia. In 2011, chest CT showed progressive thickening of his left pleura. He was diagnosed with well-differentiated papillary mesothelioma. Serial change was analyzed by immunohistochemical staining for p53 of pleural tissues. There were no remarkable changes in p53 expressions during the transformation to MM.

Keyword

Mesothelioma; Tumor Suppressor Protein p53; Pleura

MeSH Terms

Aged
Biology
Chest Pain
Diagnosis
Follow-Up Studies*
Genes, p53
Humans
Hyperplasia
Male
Mesothelioma*
Pleura
Pleural Effusion
Thorax
Tomography, X-Ray Computed
Tumor Suppressor Protein p53
Tumor Suppressor Protein p53

Figure

• 

  Figure 1 (A, D, G) In 2004, chest X-ray and computed tomography (CT) showed a moderate amount of left pleural effusion (D, white arrow) with loculation combined with mild pleural thickening and subtle enhancing area. (B, E, H) In 2008, chest CT showed progressive thickening of the left pleura with nodularity (E, white arrow). (C, F, I) In 2011, chest CT showed progressive pleural thickening with enlarged subpleural nodules (F, white arrowhead) in the left hemithorax.

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  Figure 2 Pleural tissues diagnosed of reactive hyperplasia in 2004 (A, D). There was hyperplasia of mesothelial cells (arrowhead). In 2008, it was diagnosed for atypical mesothelial hyperplasia (B, E), there there were multifocal marked proliferations of mesothelial cells, sometimes forming papillary structures (arrowhead) with myxoid fibrovascular cores (arrow). In 2011, pleural tissues diagnosed of well-differentiated papillary mesothelioma (C, F). There was marked mesothelial hyperplasia with focal papillary structures (arrowhead) (A-C, H&E stain, ×100; D-F, H&E stain, ×400).

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  Figure 3 Serial pleural tissues with p53 immunohistochemical stain in a patient in 2004, p53 focal positive staining (arrowhead) with a diagnosis of reactive mesothelial hyperplasia (A, D); focal positive stain (arrowhead) with a diagnosis of atypical mesothelial hyperplasia in 2008 (B, E); focal p53 staining (arrowhead) with well-differentiated papillary mesothelioma in 2011 (C, F) (A-C, p53 immunohistochemical stain, ×200; D-F, p53 immunohistochemical stain, ×400).

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