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The forensic significance of pseudomesotheliomatous adenocarcinoma of the lung

  • John M. KennedyEmail author
Case Report

Abstract

Pseudomesotheliomatous carcinomas (PMC) are rare tumors that clinically, macroscopically, and sometimes histologically resemble malignant pleural mesotheliomas. We report a case of a 91 year woman who was found to have diffuse nodular pleural thickening and a lung mass during a workup for persistent cough. She declined rapidly and died before a histologic diagnosis could be made. Postmortem examination revealed a tumor that diffusely involved the pleural surface with local extension into the chest wall, pericardium, and diaphragm along with a concurrent lung mass. Histologic examination showed poorly-differentiated cells predominantly arranged in sheets, cords, and nests with focal glandular differentiation. An immunohistochemical panel of calretinin, WT1, BEREP4, MOC31, and TTF1 confirmed the diagnosis of primary lung adenocarcinoma. The macroscopic, histologic, and immunohistochemical features used to distinguish metastatic and primary lung adenocarcinoma from epithelioid malignant mesothelioma are discussed. The distinction of malignant mesothelioma from pseudomesotheliomatous carcinoma is important for medicolegal reasons regarding asbestos related compensation claims.

Keywords

Pseudomesotheliomatous adenocarcinoma Lung adenocarcinoma Histopathology Mesothelioma 

Notes

Acknowledgements

Martin Ishikawa, M.D. for serving as a consultant during the autopsy prosection.

Compliance with ethical standards

Conflict of interest

The author has no conflicts of interest to report.

Ethical approval

The article does not contain any studies with human participants or animals.

Informed consent

The article does not include participants that require their informed consent.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PathologyUniversity of Michigan Medical SchoolAnn ArborUSA
  2. 2.Michigan Medicine, Department of PathologyUniversity of MichiganAnn ArborUSA

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