KATSURA Hideki    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor
Article types	Case report
Language	English
Peer review	Peer reviewed
Title	FISH analysis of intrapulmonary malignant mesothelioma without a clinically detectable primary pleural lesion: an autopsy case.
Journal	Formal name：Japanese journal of clinical oncology Abbreviation：Jpn J Clin Oncol ISSN code：(1465-3621)0368-2811(Linking)
Volume, Issue, Page	44(12),pp.1239-42
Author and coauthor	Hasegawa Mizue†*, Sakai Fumikazu, Sato Akitoshi, Tsubomizu Sayuri, Arimura Ken, Katsura Hideki, Koh Eitetsu, Sekine Yasuo, Wu Di, Hiroshima Kenzo
Publication date	2014/12
Summary	Patients with malignant mesothelioma typically present with a pleural effusion or pleural thickening and masses. A rare autopsy case of mesothelioma presenting with multiple bilateral lung nodules without clinically detectable pleural lesions is presented. A definitive diagnosis of the video-assisted thoracic surgery specimen could not be made, though a pattern of fibrosis mimicking organizing pneumonia was identified. Despite corticosteroid therapy, follow-up chest computed tomography showed enlargement of multiple nodules accompanied by the appearance of pleural thickening and effusions. The patient died of respiratory failure 11 months after initial presentation. Autopsy and retrospective analysis of the video-assisted thoracic surgery specimen using a p16 fluorescence in situ hybridization assay showed p16 homozygous deletion. The final diagnosis was sarcomatoid mesothelioma, and the lung nodules were intrapulmonary metastases from a clinically undetectable pleural sarcomatoid mesothelioma. It is important both to consider the possibility of mesothelioma with unusual clinical, radiological and pathological presentations and to remember that p16 fluorescence in situ hybridization analysis can play an important role in the diagnosis of mesothelioma.
DOI	10.1093/jjco/hyu139
PMID	25425731