Malignant mesothelioma with squamous differentiation

Histopathology. 2018 Jun;72(7):1216-1220. doi: 10.1111/his.13482. Epub 2018 Mar 30.

Abstract

Aims: We report the autopsy findings of a 58-year-old man with malignant mesothelioma in the left pleural cavity.

Methods and results: The patient had a history of asbestos exposure, and the chest computed tomography scan on initial admission demonstrated an extrapleural sign, suggesting a nodular lesion in the chest wall. However, no nodular lesions were detectable in either of his lungs. In spite of chemotherapy, he died 4 months after the initial admission. An autopsy revealed markedly thickened pleura in a large section of the left pleural cavity without visible intrapulmonary primary tumour lesions. Histological examination of a biopsy specimen obtained prior to chemotherapy and that of an autopsy specimen showed that the pleural tumour was composed of a mixture of mesothelioma and tumour cells with squamous differentiation mimicking squamous cell carcinoma.

Conclusions: To the best of our knowledge, this is the first case report of mesothelioma with extensive squamous differentiation in the English-language literature. The extensive squamous differentiation reminiscent of squamous cell carcinoma can be a pitfall in the pathological diagnosis of pleural cytology and that of biopsy specimens from patients with mesothelioma. Here, we report autopsy findings of a case of malignant mesothelioma with portions of extensive squamous differentiation, mimicking a squamous cell carcinoma.

Keywords: asbestos; malignant mesothelioma; squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / pathology
  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / pathology
  • Male
  • Mesothelioma / diagnosis*
  • Mesothelioma / pathology
  • Mesothelioma, Malignant
  • Middle Aged
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / pathology