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Kim, Kim, Jo, Lee, Park, Kim, Lee, I, Kim, and Lee: Three Cases of Malignant Pleural Mesothelioma Misdiagnosed as Tuberculous Pleurisy
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(4): 323-330.

Published online: 30 April 2007

DOI: https://doi.org/10.4046/trd.2007.62.4.323

Three Cases of Malignant Pleural Mesothelioma Misdiagnosed as Tuberculous Pleurisy

Ki Uk Kim, M.D.1, Ji Eun Kim, M.D.1, Woo Sung Jo, M.D.1, Ji Seok Lee, M.D.1, Hye Kyung Park, M.D.1, Yun Seong Kim, M.D.1, Min Ki Lee, M.D.1, Hoseok I, M.D.2, Yeong Dae Kim, M.D.2, Chang Hun Lee, M.D.3

1Department of Internal Medicine, College of Medicine, Pusan National University, Pusan, Korea.

2Department of Thoracic Surgery, College of Medicine, Pusan National University, Pusan, Korea.

3Department of Pathology, College of Medicine, Pusan National University, Pusan, Korea.

Address for correspondence: Yeong Dae Kim, M.D. Department of Thoracic Surgery, College of Medicine, Pusan National University, 1-10 Ami-dong, Seo-gu, Pusan, 602-739, Korea. Phone: 82-51-240-7267, Fax: 82-51-243-9389, domini@pnu.edu

Received 28 December 2006       Accepted 8 March 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Malignant pleural mesothelioma(MPM) is an uncommon neoplasm which is originated from pleural mesothelial cells. The majority of MPM is associated with prior asbestos exposure. Patients often present with chest pain and dyspnea due to pleural effusion, which might be diagnosed with tuberculous pleurisy especially in Korea. MPM is well known for its poor prognosis with a median survival time of less than 12 months after diagnosis and no established standard treatment modality. We report 3 cases of MPM confirmed by video-assisted thoracoscopic biopsy first misdiagnosed as tuberculous pleurisy.

Keywords: Malignant pleural mesothelioma, Tuberculous pleurisy, Thoracoscopy

Figures and Tables

Figure 1
(A) Chest radiograph shows pleural effusion in the left hemithorax. (B) Contrast enhanced chest CT scan shows circumferential and nodular pleural thickening.
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Figure 2
(A) Malignant epithelielial mesothelioma showing diffuse solid growth of atypical polygonal cells with abundant pale eosinophilic cytoplasm (H-E stain, ×400). (B) The tumor cells with strong nuclear and cytoplasmic immunoeactivity for calretinin (Streptavidin-biotin, ×400).
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Figure 3
(A) Chest radiograph shows loculated pleural effusion with passive atelectasis in the right lung. (B) Contrast enhanced chest CT scan shows pleural effusion with pleural mass.
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Figure 4
(A) Malignant epithelial mesothelioma showing solid nests of atypical polygonal mesothelial cells (H-E stain, ×400). (B) The tumor cells with strong nuclear and cytoplasmic immunoreactivity for calretinin (Streptavidin-biotin, ×400).
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Figure 5
(A) Chest radiograph shows pleural effusion in the right lung. (B) Contrast enhanced chest CT scan shows pleural effusion with metastatic nodules on chest wall.
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Figure 6
(A) Malignant pleural mesothelioma showing the same histologic featue as cases 1 and 2 (H-E stain, ×400). (B) The infiltrating tumor cells with strong cytoplasmic immunoreactivity for high molecular weight cytokeratin (Streptavidin-biotin, ×400).
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Table 1
Clinical signs and symptoms of 23 MPM patients
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Table 2
Diagnostic approaches of 23 MPM patients
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Table 3
Treatment of 23 MPM patients
trd-62-323-i003

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