case_images: PMC9160749_01
case_images: (A) Chest CT showing a ground glass opacity of 32 mm in size in her middle lobe of the right lung. (B) At 2 years and 3 months after pulmonary resection, the follow-up chest CT revealed right pleural effusion. (C-F) At 4 year and 7 months after pulmonary resection, the chest CT revealed multiple pulmonary nodules and bilateral pleural effusion with a right pleural tumor directly invading into the abdominal cavity. A right malignant pleural mesothelioma (sarcomatoid type) invaded to the right adrenal gland and the liver.
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case_images: f1
case_images: She underwent a right middle lobectomy and nodal dissection for pulmonary AD which showed a ground glass opacity of 32 mm in size ( Figure 1A ). At 2 years and 3 months after the pulmonary resection, the follow-up chest CT revealed a right pleural effusion ( Figure 1B ). At 4 years and 7 months after the pulmonary resection, the chest CT revealed multiple pulmonary nodules and bilateral pleural effusion with a right pleural tumor directly invading into the abdominal cavity ( Figures 1C-F ).
case_images: (A) Pathology of primary lung cancer (x100). (B) TTF-1 of lung cancer (positive; x400). (C) Calretinin of lung cancer (negative; x400). (D) Pathology of malignant pleural mesothelioma (x200). (E) Calretinin of malignant pleural mesothelioma (MPM; weakly positive; x400). (F) D2-40 of MPM (positive; x400).
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case_images: PMC9160749_01_fonc-12-858094-g002.jpg
case_images: f2
case_images: For this diagnosis, we used not only morphological methods but also immunohistochemistry methods ( Figures 2A-C ). TTF-1, Napsin A, or p40 and weakly positive for calretinin and positive for D2-40 ( Figures 2D-F ), which meant a mesothelium origin. The pathology was quite different from the adenocarcinoma.
case_images: Structural chromosomal aberration analysis by DNA microarray (OncoScan CNV). All chromosomes showed abnormality in malignant pleural mesothelioma, whereas the chromosomal aberration of lung adenocarcinoma was relatively local. A commonality was not found in the patterns of the chromosomal aberration between the adenocarcinoma and the malignant pleural mesothelioma.
case_images: fonc-12-858094-g003.jpg
case_images: PMC9160749_01_fonc-12-858094-g003.jpg
case_images: f3
case_images: In the structural chromosomal aberration analysis by DNA microarray with OncoScan CNV (Affymetrix) ( Figure 3 ), all chromosomes of the MPM showed abnormality, whereas the chromosomal aberration of AD showed relatively local abnormality.