BACKGROUND Primary malignant pericardial mesothelioma(PMPM)is an extremely rare malignant tumor,and it is difficult to diagnose definitively before death.We present a case in which PMPM was diagnosed at autopsy.We con...BACKGROUND Primary malignant pericardial mesothelioma(PMPM)is an extremely rare malignant tumor,and it is difficult to diagnose definitively before death.We present a case in which PMPM was diagnosed at autopsy.We consider this case to be highly suggestive and report it here.CASE SUMMARY A 78-year-old male presented with transient loss of consciousness and falls.The transient loss of consciousness was considered to result from complications of diastolic dysfunction due to pericardial disease,fever with dehydration,and paroxysmal atrial fibrillation.Ultrasound cardiography(UCG)and computed tomography showed cardiac enlargement and high-density pericardial effusion.We considered pericardial disease to be the main pathogenesis of this case.Cardiac magnetic resonance imaging and gadolinium contrast-enhanced T1-weighted images showed thick staining inside and outside the pericardium.Pericardial biopsy was considered to establish a definitive diagnosis,but the patient and his family refused further treatment and examinations,and the patient was followed conservatively.We noticed a thickening of the pericardium and massive changes in the pericardium on UCG over time.We performed an autopsy 60 h after the patient died of pneumonia.Giemsa staining of the autopsy tissue showed an epithelial-like arrangement in the pericardial tumor,and immunostaining showed positive and negative factors for the diagnosis of PMPM.Based on these findings,the final diagnosis of PMPM was made.CONCLUSION PMPM has a poor prognosis,and early diagnosis and treatment are important.The temporal echocardiographic findings may provide a clue for the diagnosis of PMPM.展开更多
Malignant pleural mesothelioma is a rare primary tumor rising from the pleura and is associated with exposure to asbestos fibers. Mesothelioma is a locally aggressive disease that usually presents at an advanced stage...Malignant pleural mesothelioma is a rare primary tumor rising from the pleura and is associated with exposure to asbestos fibers. Mesothelioma is a locally aggressive disease that usually presents at an advanced stage and has a median overall survival of 1 year. Treatment options rarely result in cure of disease and range from trimodality treatment, including chemotherapy, radiation, and surgery, to supportive care. In patients with limited local disease and good functional status, trimodality treatment with extra-pleural pneumonectomy, chemotherapy, and radiation is frequently employed. Best supportive care should be instituted for patients with metastatic disease and poor functional status. Palliative therapy focuses on control of pleural effusions with drainage techniques and pain with radiation therapy. Novel therapies are showing promise, including photodynamic therapy, immunotherapy, and molecular targeted therapy.展开更多
Objective: To summarize the experience in the diagnosis of mesothelioma. Methods: Analyzing the clinical data of 19 patients with pleural mesothelioma, including age, history of exposure to asbestos, clinical manifest...Objective: To summarize the experience in the diagnosis of mesothelioma. Methods: Analyzing the clinical data of 19 patients with pleural mesothelioma, including age, history of exposure to asbestos, clinical manifestations, imaging and laboratory examinations and metastases. Results: None of the 19 patients had a history of exposure to asbestos. Eight cases (42.1%) had no obvious thoracodynia, 9 cases (47.4%) had pleural effusion limited to the right chest, and in 2 cases (10.5%) the brachialis plexus was involved, and in 1 case (5.3%) malignant mesothelial cells were detected in the pleural effusion. Pleural thickening or nodules were found in 13 cases on CT and in 9 cases by B ultrasonographic examination. Conclusion: Exposure to asbestos is not the only cause of pleural mesothelioma. Chest pain is not always associated with pleural mesothelioma. CT and B ultrasonography are a help in the diagnosis of pleural mesothelioma.展开更多
Benign multicystic peritoneal mesothelioma(BMPM)is a rare tumor originating from peritoneal mesothelial cells.Here,we present a case of an 18-year-old male with right lower abdominal pain.Physical examination revealed...Benign multicystic peritoneal mesothelioma(BMPM)is a rare tumor originating from peritoneal mesothelial cells.Here,we present a case of an 18-year-old male with right lower abdominal pain.Physical examination revealed a palpable mass with unclear boundaries.Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein.CT scan revealed a cystic mass in the ileocecal region with multiple septations.Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side.Immunohistochemistry confirmed BMPM diagnosis.BMPM,especially in the ileocecal region,is uncommon and presents diagnostic challenges.Differential diagnosis includes lymphangioma,peritoneal metastasis,and malignant mesothelioma.CT findings,such as thin cyst walls and septations,aid in diagnosis.Recognition of BMPM’s imaging features improves diagnostic accuracy.Surgical resection remains the primary treatment.This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.展开更多
Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chie...Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years.The physical examination revealed a palpable painful mass.Computed tomography demonstrated an irregular,cystic tumor in his right lower abdomen.There was no obvious capsule or internal septations.No enhancement after intravenous administration of contrast was noted.An exploratory laparotomy was performed,and a multicystic tumor and adherent to the caecum was noted.The walls of the cysts were thin and smooth,filled with clear fluid,and very friable.An en bloc resection of the tumor,including appendix and caecum,was performed.Histological examination revealed multiple cysts lined with flattened simple epithelial cells,and the capsule walls of the cysts were composed of fibrous tissue.Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin.The final diagnosis was BMPM.The patient was well at 6-mo follow-up.BMPM is exceedingly rare lesion.A complete resection of the tumor is required.The diagnosis of BMPM is based on pathological analysis.展开更多
Objective:To investigate the significance of computed tomography findings in diffuse malignant peritoneal mesothelioma(DMPeM),tuberculous peritonitis(TBP),and peritoneal carcinomatosis(PC)to differentiate the three di...Objective:To investigate the significance of computed tomography findings in diffuse malignant peritoneal mesothelioma(DMPeM),tuberculous peritonitis(TBP),and peritoneal carcinomatosis(PC)to differentiate the three diseases.Methods:The clinical manifestation and computed tomography scans of 147 patients with diffuse malignant peritoneal mesothelioma(n=60),tuberculous peritonitis(n=32),and peritoneal carcinomatosis(n=55)were retrospectively reviewed,while taking into account of ascites,pleural plaques,viscera infiltration;abnormalities in the peritoneum;involvement of the mesentery and omentum;as well as the presence and location of enlarged lymph nodes.Results:There was no significant difference among all three groups in terms of clinical manifestation,peritoneum,omentum,and mesentery involvement,ascites,as well as the presence and location of enlarged lymph nodes.The study found that 95%of DMPeM patients had been exposed to asbestos in the past.The patients showed significant differences in the following aspects:(1)irregular peritoneum thickening,caked omentum thickening,pleural plaques,visceral infiltration,and asbestos exposure were more common in peritoneal mesothelioma patients;(2)nodular peritoneum thickening and visceral metastasis were more common in patients with peritoneal carcinomatosis;(3)smooth peritoneal thickening,pleural effusion,and extraperitoneal tuberculosis were more common in patients with tuberculous peritonitis.Conclusion:A combination of computed tomography findings could improve our ability in differentiating the three diseases.展开更多
文摘BACKGROUND Primary malignant pericardial mesothelioma(PMPM)is an extremely rare malignant tumor,and it is difficult to diagnose definitively before death.We present a case in which PMPM was diagnosed at autopsy.We consider this case to be highly suggestive and report it here.CASE SUMMARY A 78-year-old male presented with transient loss of consciousness and falls.The transient loss of consciousness was considered to result from complications of diastolic dysfunction due to pericardial disease,fever with dehydration,and paroxysmal atrial fibrillation.Ultrasound cardiography(UCG)and computed tomography showed cardiac enlargement and high-density pericardial effusion.We considered pericardial disease to be the main pathogenesis of this case.Cardiac magnetic resonance imaging and gadolinium contrast-enhanced T1-weighted images showed thick staining inside and outside the pericardium.Pericardial biopsy was considered to establish a definitive diagnosis,but the patient and his family refused further treatment and examinations,and the patient was followed conservatively.We noticed a thickening of the pericardium and massive changes in the pericardium on UCG over time.We performed an autopsy 60 h after the patient died of pneumonia.Giemsa staining of the autopsy tissue showed an epithelial-like arrangement in the pericardial tumor,and immunostaining showed positive and negative factors for the diagnosis of PMPM.Based on these findings,the final diagnosis of PMPM was made.CONCLUSION PMPM has a poor prognosis,and early diagnosis and treatment are important.The temporal echocardiographic findings may provide a clue for the diagnosis of PMPM.
文摘Malignant pleural mesothelioma is a rare primary tumor rising from the pleura and is associated with exposure to asbestos fibers. Mesothelioma is a locally aggressive disease that usually presents at an advanced stage and has a median overall survival of 1 year. Treatment options rarely result in cure of disease and range from trimodality treatment, including chemotherapy, radiation, and surgery, to supportive care. In patients with limited local disease and good functional status, trimodality treatment with extra-pleural pneumonectomy, chemotherapy, and radiation is frequently employed. Best supportive care should be instituted for patients with metastatic disease and poor functional status. Palliative therapy focuses on control of pleural effusions with drainage techniques and pain with radiation therapy. Novel therapies are showing promise, including photodynamic therapy, immunotherapy, and molecular targeted therapy.
文摘Objective: To summarize the experience in the diagnosis of mesothelioma. Methods: Analyzing the clinical data of 19 patients with pleural mesothelioma, including age, history of exposure to asbestos, clinical manifestations, imaging and laboratory examinations and metastases. Results: None of the 19 patients had a history of exposure to asbestos. Eight cases (42.1%) had no obvious thoracodynia, 9 cases (47.4%) had pleural effusion limited to the right chest, and in 2 cases (10.5%) the brachialis plexus was involved, and in 1 case (5.3%) malignant mesothelial cells were detected in the pleural effusion. Pleural thickening or nodules were found in 13 cases on CT and in 9 cases by B ultrasonographic examination. Conclusion: Exposure to asbestos is not the only cause of pleural mesothelioma. Chest pain is not always associated with pleural mesothelioma. CT and B ultrasonography are a help in the diagnosis of pleural mesothelioma.
文摘Benign multicystic peritoneal mesothelioma(BMPM)is a rare tumor originating from peritoneal mesothelial cells.Here,we present a case of an 18-year-old male with right lower abdominal pain.Physical examination revealed a palpable mass with unclear boundaries.Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein.CT scan revealed a cystic mass in the ileocecal region with multiple septations.Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side.Immunohistochemistry confirmed BMPM diagnosis.BMPM,especially in the ileocecal region,is uncommon and presents diagnostic challenges.Differential diagnosis includes lymphangioma,peritoneal metastasis,and malignant mesothelioma.CT findings,such as thin cyst walls and septations,aid in diagnosis.Recognition of BMPM’s imaging features improves diagnostic accuracy.Surgical resection remains the primary treatment.This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.
文摘Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years.The physical examination revealed a palpable painful mass.Computed tomography demonstrated an irregular,cystic tumor in his right lower abdomen.There was no obvious capsule or internal septations.No enhancement after intravenous administration of contrast was noted.An exploratory laparotomy was performed,and a multicystic tumor and adherent to the caecum was noted.The walls of the cysts were thin and smooth,filled with clear fluid,and very friable.An en bloc resection of the tumor,including appendix and caecum,was performed.Histological examination revealed multiple cysts lined with flattened simple epithelial cells,and the capsule walls of the cysts were composed of fibrous tissue.Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin.The final diagnosis was BMPM.The patient was well at 6-mo follow-up.BMPM is exceedingly rare lesion.A complete resection of the tumor is required.The diagnosis of BMPM is based on pathological analysis.
文摘Objective:To investigate the significance of computed tomography findings in diffuse malignant peritoneal mesothelioma(DMPeM),tuberculous peritonitis(TBP),and peritoneal carcinomatosis(PC)to differentiate the three diseases.Methods:The clinical manifestation and computed tomography scans of 147 patients with diffuse malignant peritoneal mesothelioma(n=60),tuberculous peritonitis(n=32),and peritoneal carcinomatosis(n=55)were retrospectively reviewed,while taking into account of ascites,pleural plaques,viscera infiltration;abnormalities in the peritoneum;involvement of the mesentery and omentum;as well as the presence and location of enlarged lymph nodes.Results:There was no significant difference among all three groups in terms of clinical manifestation,peritoneum,omentum,and mesentery involvement,ascites,as well as the presence and location of enlarged lymph nodes.The study found that 95%of DMPeM patients had been exposed to asbestos in the past.The patients showed significant differences in the following aspects:(1)irregular peritoneum thickening,caked omentum thickening,pleural plaques,visceral infiltration,and asbestos exposure were more common in peritoneal mesothelioma patients;(2)nodular peritoneum thickening and visceral metastasis were more common in patients with peritoneal carcinomatosis;(3)smooth peritoneal thickening,pleural effusion,and extraperitoneal tuberculosis were more common in patients with tuberculous peritonitis.Conclusion:A combination of computed tomography findings could improve our ability in differentiating the three diseases.
文摘目的探索免疫治疗在恶性胸膜间皮瘤(malignant pleural mesothelioma,MPM)中免疫疗效相关关键分子及其可能的机制。方法2018年7月至2020年7月,纳入GEO数据库中GSE117358的表达谱进行分析;首先,根据是否对免疫治疗是否有效分为两组:免疫治疗反应组和免疫治疗无反应组,同时分析两组之间差异有统计学意义基因;其次,分析两组差异有统计学意义基因在基因本体(gene ontology,GO)生物学行为及京都基因与基因组百科全书(Kyoto encyclopedia of genes and ge‐nomes,KEGG)富集信号通路等方面的差异;最后,对差异有统计学意义基因构建蛋白-蛋白互作网络,筛选在生物学行为中的重要模块及关键基因,并对关键基因在TCGA数据库中进行整合分析验证。结果在免疫治疗反应组(12个样本)及免疫治疗无反应组(12个样本)中共筛选出1025个差异基因,相对于免疫治疗无反应组,在免疫治疗反应组中有782个上调和243个下调基因。GO和KEGG分析显示,这些差异基因的功能主要集中在细胞因子受体通路、细胞黏附通路、T细胞受体通路及NFkappa B信号通路等;在蛋白-蛋白互作网络分析中,筛选出节点度最高的10个核心基因包括Tnf,Il6,Ptprc,Csf2,Cd86,Cxcl9,Sell,Cxcr3,Ccl2,Cd40。TCGA数据库整合分析显示,Tnf,Il6,Cd86,Cxcl9,Sell,Cxcr3,Cd40等疗效相关关键基因在肉瘤样胸膜间皮瘤中呈现相对高表达,且差异有统计学意义。结论核心基因Tnf,Il6,Ptprc,Csf2,Cd86,Cxcl9,Sell,Cxcr3,Ccl2,Cd40有望成为预测MPM的分子标志物及治疗的潜在靶点。
