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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

An autopsy case of primary malignant pericardial mesothelioma with a history of asbestos exposure

Keishi Sekiguchia,b  Tetsuro Hanafusac  Kota Ochiaic  Hiroshi Fukushimac  Tamiki Oshimac  Shigeo Kinod 

aNishiyodo Hospital
bSt. Lucia's Hospital
cDepartment of General Internal Medicine, Nishiyodo Hospital
dDepartment of Clinical Pathology, Mimihara General Hospital

ABSTRACT

A 69-year-old man with supposed malignant mesothelioma who had a history of exposure to asbestos and signs of calcified pleural plaque and pleural fluid on radiographic examination was admitted to our hospital for palliative care. His chief complaint was general fatigue. Respiratory symptoms were absent, except for increased expectoration. He died of respiratory failure as a result of aspiration pneumonia 44 days after admission. Life history revealed high dense exposure to asbestos while for a long period he was a plumber working on trains. Autopsy elucidated that the tumor mostly involved the pericardial cavity and was derived from pericardium, not pleura. Histological analysis revealed a biphasic type of mesothelioma. Immunohistochemical analysis revealed that the tumor comprised mesothelial cells positive for calretinin and negative for carcinoembryonic antigen. Pathological analysis concluded that the tumor represented a biphasic type of primary malignant pericardial mesothelioma (PMPM). A relationship between PMPM and asbestos has been suggested in recent studies; however, few case reports have described PMPM associated with asbestos exposure. Our report described a case with definitive pathological diagnosis of PMPM associated with a history of exposure to asbestos based on a survey of previous employers of the patient.

KEYWORDS

Asbestos  Primary malignant pericardial mesothelioma  Autopsy 

Received 12 Apr 2014 / Accepted 4 Dec 2014

AJRS, 4(2): 153-157, 2015

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