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Primary localized malignant biphasic mesothelioma of the liver in a patient with asbestosis

World Journal of Gastroenterology 2009年第5期15卷 615-621页

作者： Motoko Sasaki Ichiro Araki Toshiaki Yasui Masaru Kinoshita Keita Itatsu Takayuki Nojima Yasuni Nakanuma Department of Human Pathology Kanazawa University Graduate School of Medicine Kanazawa 920-8640 Japan Department of Internal Medicine Asanogawa General Hospital Kanazawa 920-8621 Japan Department of Surgery Asanogawa General Hospital Kanazawa 920-8621 Japan Hanazono Medical Office Kanazawa 920-0293 Japan Department of Pathology Kanazawa Medical University Ishikawa 920-0293 Japan

We report a case of primary localized malignant biphasic mesothelioma of the liver in a 66-year-old man associated with asbestosis. The tumor was detected as a hepatic nodule, 4 cm in diameter, in the right lobe (S8 segment) on CT scan. Histopathological examination demonstrated an intrahepatic tumor with central necrosis consisting of a papillary epithelioid pattern on the surface of the liver, microcystic (microglandular or adenomatoid) pattern mainly in the subcapsular area and sarcomatoid pattern intermingled with microcystic pattern in the major part of the hepatic nodular tumor. Tumor cells, especially of epithelioid type, showed distinct immunoreactivity for mesothelial markers (WT-1, calretinin, D2-40, CK5/6, mesothelin, thrombomodulin) and no immunoreactivity for epithelial (adenocarcinoma) markers (CEA, CD15, BerEP4, BG8, MOC31). P53 immunoreactivity was detected focally in papillary epithelioid tumor cells and extensively in microcystic and sarcomatoid components, suggesting that the papillary epithelioid mesothelioma arose on the surface of the liver, and tumor cells showing microcystic and sarcomatoid patterns invaded and grew into the liver. To date, this is the first case of primary localized malignant biphasic mesothelioma of the liver, since all three primary hepatic mesotheliomas reported so far were epithelioid type.

关键词： Malignant mesothelioma pulmonaryasbestosis Liver Immunohistochemistry

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