SESSION TITLE: Pleural Student/Resident Case Report Posters
SESSION TYPE: Medical Student/Resident Case Report
PRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PM
INTRODUCTION: Lymphohistiocytoid mesothelioma is a rare subtype of malignant pleural mesothelioma (MPM). There are few cases reported that systemic chemotherapy was effective for the subtype. We report a case of lymphohistiocytoid mesothelioma with response to the systemic chemotherapy consisted of cisplatin and pemetrexed.
CASE PRESENTATION: A 72-year-old man came to our hospital because of abnormal shadows of the chest determined at a semiannual medical checkup. He had smoked for 8 years to 35 years old, and had been exposed to asbestos at shipyards for 3 years at the age of teens. A computed tomography (CT) scan of the chest showed multiple mass on the parietal pleura, diaphragm, and the interlobar pleura of the right. A CT-guided percutaneous needle lung biopsy was performed and the biopsy specimen demonstrated fibrous thickening of the pleura with an abundance of lymphocyte infiltration. Immunohistochemical analysis revealed that the cells were positive for calretinin, CK AE1/3, and WT-1, and negative for CEA, CAM5.2, TTF-1, NapsinA, LZM, and CD68. Based on these findings, the diagnosis was confirmed as lymphohistiocytoid mesothelioma. Systematic chemotherapy consisting of cisplatin (75mg/m2) and pemetrexed (500mg/m2) was delivered, and the multiple mass of the pleura exhibited a significant regression. He has been in the maintenance treatment after 6 cycles of the chemotherapy.
DISCUSSION: Lymphohistiocytoid mesothelioma is an infrequent variant of MPM. Previously its characteristics were considered similar to those of sarcomatous MPM, but the recent report suggested that it has some clinical features close to epithelioid MPM. There are few reports concerning the treatment of the subtype. In this case, the combination therapy of cisplatin and pemetrexed demonstrated a significant regression of the tumor. It would be a favorable treatment option against lymphohistiocytoid mesothelioma.
CONCLUSIONS: We reported the lymphohistiocytoid mesothelioma, a rare subtype of MPM.
Reference #1: Pathol Int. 2010 Aug;60(8):566-74. doi: 10.1111/j.1440-1827.2010.02560.x. Lymphohistiocytoid mesothelioma of the pleura. Kawai T1, Hiroi S, Nakanishi K, Takagawa K, Haba R, Hayashi K, Kawachi K, Nozawa A, Hebisawa A, Nakatani Y
DISCLOSURE: The following authors have nothing to disclose: Yosuke Miyamoto, Nobukazu Fujimoto, Naofumi Hara, Michiko Asano, Yasuko Fuchimoto, Kenichi Kitamura, Shinji Ozaki, Takumi Kishimoto
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