Malignant mesothelioma with squamous differentiation

Abstract

We report the autopsy findings of a 58-year-old man with malignant mesothelioma in the left pleural cavity. The patient had a history of asbestos exposure, and the chest computed tomography on initial admission demonstrated an extrapleural sign suggesting a nodular lesion in the chest wall. However, no nodular lesions were detectable in either of his lungs. In spite of chemotherapy, the patient died 4 months after the initial admission. An autopsy revealed markedly thickened pleura in a large section of the left pleural cavity without visible intrapulmonary primary tumor lesions. Histological examination of a biopsy specimen obtained prior to chemotherapy and that of an autopsy specimen showed that the pleural tumor was composed of a mixture of mesothelioma and tumor cells with squamous differentiation mimicking squamous cell carcinoma. To the best of our knowledge, this is the first case report of mesothelioma with extensive squamous differentiation in English literature. The extensive squamous differentiation reminiscent of squamous cell carcinoma can be a pitfall in the pathological diagnosis of pleural cytology and that of biopsy specimens from patients with mesothelioma. Here, we report autopsy findings of a case of malignant mesothelioma with portions of extensive squamous differentiation, mimicking a squamous cell carcinoma.

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