Journal List > Tuberc Respir Dis > v.62(4) > 1001082

Kim, Kim, Jo, Lee, Park, Kim, Lee, I, Kim, and Lee: Three Cases of Malignant Pleural Mesothelioma Misdiagnosed as Tuberculous Pleurisy


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.

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.
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).
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.
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).
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.
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).
Table 1
Clinical signs and symptoms of 23 MPM patients
Table 2
Diagnostic approaches of 23 MPM patients
Table 3
Treatment of 23 MPM patients


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