CASE OF THE MONTH

Malignant Mesothelioma, Epitheliod Type

A 70 year old gentleman presented with right chest pain.  Chest X-Ray showed multiple pleural based nodules.  Open biopsy yielded solid tan rubbery well circumscribed pieces of tissue without evidence of degenerative change.  Histologic sections showed cytologically malignant cells arranged in nests with focal papillary and gland-like formations.  Invasion into adjacent stroma (fat) was evident.  Immunoperoxidase stains were strongly positive for Calretinin, CK5, and Thrombomodulin.  No staining was seen with CD15, TTF-1, Napsin A, or polyclonal CEA.  A diagnosis of malignant mesothelioma, epithelioid Type, was made.

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