PMC5467287_01
(a) An axial high-resolution chest CT scan showed extensive bronchovascular bundle and septal thickening and a consolidative mass in the upper lobe of the right lung; these findings are consistent with the lymphangitic spread of the tumor. (b) The gross pathological findings of the lung and pleura at autopsy showing multiple pleural nodules and masses on the pleural surface. The lung parenchyma is encased by tumor growth and the lymphatic spread of the tumor is observed. (c) Light microscopy of the resected pleural tumor. The lesion was histologically diagnosed as epithelioid-type malignant pleural mesothelioma. The marked invasion of the lymphatic vessel by tumor cells was observed (hematoxylin and eosin staining, x100). (d) On immunohistochemical staining, the tumor cells were positive for calretinin, a mesothelial cell marker.
CRIONM2017-6195898.001.jpg
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fig1
The tumor was found to be primarily located in the right pleura invading the pulmonary parenchyma (Figure 1(b)). The tumor cells were epithelioid cells with eosinophilic cytoplasm infiltrating the pulmonary parenchyma with the lymphatic spread of the tumor (Figure 1(c)). An immunohistochemical examination was positive for calretinin and D2-40 and negative for TTF-1, SP-A, Ber-EP4, and carcinoembryonic antigen (CEA) (Figure 1(d)).
PMC5467287_02
(a) An axial high-resolution chest CT scan showed extensive bronchovascular bundle and septal thickening and a consolidative mass in the upper lobe of the right lung; these findings are consistent with the lymphangitic spread of the tumor. (b) The gross pathological findings of the lung and pleura at autopsy showing multiple pleural nodules and masses on the pleural surface. The lung parenchyma is encased by tumor growth and the lymphatic spread of the tumor is observed. (c) Light microscopy of the resected pleural tumor. The lesion was histologically diagnosed as epithelioid-type malignant pleural mesothelioma. The marked invasion of the lymphatic vessel by tumor cells was observed (hematoxylin and eosin staining, x100). (d) On immunohistochemical staining, the tumor cells were positive for calretinin, a mesothelial cell marker.
CRIONM2017-6195898.001.jpg
PMC5467287_02_CRIONM2017-6195898.001.jpg
fig1
The tumor was found to be primarily located in the right pleura invading the pulmonary parenchyma (Figure 1(b)). The tumor cells were epithelioid cells with eosinophilic cytoplasm infiltrating the pulmonary parenchyma with the lymphatic spread of the tumor (Figure 1(c)). An immunohistochemical examination was positive for calretinin and D2-40 and negative for TTF-1, SP-A, Ber-EP4, and carcinoembryonic antigen (CEA) (Figure 1(d)).
(a) An axial chest CT scan showed extensive bronchovascular bundle and septal thickening, an upper lobe consolidative mass, and perilymphatic nodules in the left lung; these findings are consistent with the lymphangitic spread of the tumor. (b) A contrast-enhanced chest CT scan showing a left upper lobe consolidative mass, left-sided pleural effusion, and pleural thickening with mediastinal lymph node swelling. (c) The gross pathological findings of the lung and pleura at autopsy. The lung parenchyma is encased by tumor growth and the lymphatic spread of the tumor is observed. (d) A low-power magnification view of the pleural tumor. The tumor is composed of epithelioid and spindle cells (hematoxylin and eosin staining, x100). (e) Low-power magnification of the pleural tumor. The lesion was histologically diagnosed as biphasic-type malignant pleural mesothelioma. The photomicrograph shows invasion of the lymphatic channels by the tumor (hematoxylin and eosin staining, x100).
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fig2
A CT scan performed after four cycles of chemotherapy with the combination of cisplatinum and pemetrexed revealed left-sided pleural effusion, a consolidative mass with bronchovascular bundle, and septal thickening, suggesting lung parenchymal involvement and the lymphatic spread of the tumor (Figures 2(a) and 2(b)). Metastasis to the mediastinal lymph nodes with peritoneal metastasis and ascites were also present (Figure 2(b)). The tumor was found to be primarily located in the left pleura invading the lung parenchyma (Figure 2(c)). Microscopically, the tumor cells were a biphasic lesion of malignant pleural mesothelioma (Figure 2(d)) and invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor (Figure 2(e)).