Localized Malignant Mesothelioma: A Clinicopathologic and Flow Cytometric Study
Localized Malignant Mesothelioma: A Clinicopathologic and Flow Cytometric Study
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局限性恶性间皮瘤：临床病理学和流式细胞术研究
DOI：
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发表时间：
1994
影响因子：
5.6
通讯作者：
A. Churg
中科院分区：
文献类型：
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作者：
T. Crotty;J. Myers;A. Katzenstein;H. Tazelaar;S. Swensen;A. Churg
六例恶性间皮瘤出现局部胸膜肿块描述。有四名妇女和两名男子，年龄从42岁到76岁不等。从三名患者中获得了石棉暴露史。肿瘤大小为2.8 ~ 10 cm。两个是有蒂的，四个是无柄与广泛的胸膜附件。组织学上，三个肿瘤是纯上皮样的，三个是双相的。免疫组化染色均为角蛋白阳性，癌胚抗原阴性。5例上皮膜抗原阳性。五个是阴性的Leu-M1，而一个显示局灶性染色的外周膜模式。在两个纯上皮样肿瘤的电子显微镜下显示长，薄的微绒毛，发育良好的桥粒，和许多张力细丝。流式细胞术显示，非整倍体DNA含量在四个肿瘤和二倍体含量在一个。流式细胞术在五个案例中确定了DNA非整倍体细胞群体在四个肿瘤和二倍体人口。3例患者在切除后4、7和18个月出现局部复发的迹象，并分别在诊断后12、10和24个月死于疾病。三名患者在诊断后8个月、24个月和96个月都没有疾病迹象。这些发现表明，恶性间皮瘤的胸膜可能很少出现作为一个局部肿块。这种肿瘤的生物学行为很难预测，但有些患者在手术切除后长时间无病生存。
Six examples of malignant mesothelioma appearing as a localized pleural mass are described. There were four women and two men, ranging in age from 42 to 76 years. A history of asbestos exposure was obtained from three patients. The tumors ranged in size from 2.8 to 10 cm. Two were pedunculated and four were sessile with broad-based pleural attachments. Histologically, three tumors were purely epithelioid and three were biphasic. Immunohistochemical stains in all six cases were positive for cytokeratin and negative for carcinoembryonic antigen. Five were also positive for epithelial membrane antigen. Five were negative for Leu-M1, while one showed focal staining in a peripheral membrane pattern. Electron microscopy in two purely epithelioid tumors showed long, thin microvilli, well-developed desmosomes, and numerous tonofilaments. Flow cytometry showed an aneuploid DNA content in four tumors and a diploid content in one. Flow cytometry in five cases identified a DNA aneuploid cell population in four tumors and a diploid population in one. Three patients showed signs of local recurrences 4, 7, and 18 months after excision and died of their disease 12, 10, and 24 months after diagnosis, respectively. Three patients are well with no evidence of disease 8, 24, and 96 months after diagnosis. These findings indicate that malignant mesotheliomas of the pleura may rarely appear as a localized mass. The biologic behavior of such tumors is difficult to predict, but some patients survive disease-free for a long time after surgical excision.