Respir Case Rep. 2015; 4(1): 29-33 | DOI: 10.5505/respircase.2015.94695

Malignant Pleural Mesothelioma at a Young Age

Ýlknur Baþyiðit¹, Haþim Boyacý¹, Esra Kuþlu Uçar¹, Kürþat Yýldýz², Aslý Gül Akgül³, Serap Argun Barýþ¹, Füsun Yýldýz^1
1Department of Pulmonary Diseases, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
²Department of Pathology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
³Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey

Malignant mesothelioma is a tumor with poor prog-nosis that usually occurs 20-40 years after asbestos exposure. Here, we present a 27-year-old patient with malignant pleural mesothelioma who did not report any asbestos exposure. A female non-smoker was admitted with complaints of chest pain and dyspnea. The physical examination revealed dullness with percussion in the right lower lobe. There was a free-flowing pleural effusion through the right middle zone and bilaterally nodular opacities in chest x-ray. The ADA level, ARB and mycobacterium culture of the pleural fluid were negative. There were some malignant cells in the cytological examination of the fluid, and therefore the primary site of malignancy was evaluated. Thoracoscopy revealed nodular tumoral infiltration in the parietal pleura and thickness of the visceral layer. The pathological examination and immunostaining of the biopsy specimens were reported as biphasic malignant mesothelioma. In conclusion, mesothelioma should be considered in the case of malignant pleural effusion and detailed immunostaining should be performed in order to ascertain the diagnosis.

Keywords: Young age, pleural effusion, immunostaining, podoplanin, mesothelioma.

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Genç Yaþta Görülen Malign Plevral Mezotelyoma Olgusu

Ýlknur Baþyiðit¹, Haþim Boyacý¹, Esra Kuþlu Uçar¹, Kürþat Yýldýz², Aslý Gül Akgül³, Serap Argun Barýþ¹, Füsun Yýldýz^1
1Kocaeli Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Anabilim Dalý, Kocaeli
²Kocaeli Üniversitesi Týp Fakültesi, Patoloji Anabilim Dalý, Kocaeli
³Kocaeli Üniversitesi Týp Fakültesi, Göðüs Cerrahisi Anabilim Dalý, Kocaeli

Malign mezotelyoma asbest temasýndan 20-40 yýl sonra ortaya çýkan, prognozu kötü bir tümördür. Burada 27 yaþýnda, bilinen asbest temasý olmayan bir malign plevral mezotelyoma olgusu sunulmuþtur. Sigara öyküsü olmayan bayan hasta nefes darlýðý ve yan aðrýsý ile baþvurdu. Fizik muayenede, sað alt zonda matite tespit edilen hastanýn akciðer grafisinde saðda orta zona kadar uzanan serbest plevral efüzyon ve her iki akciðerde multipl, nodüler dansiteler saptandý. Plevral sývý incelemesinde hemorajik karakterde eksüdatif efüzyon izlendi. Plevral sývýn ADA seviyesi, ARB ve mikobakteri kültürü negatif bulundu. Sývý sitolojisi malignite açýsýndan kuþkulu bulunan hastada primer odak araþtýrmasý yapýldý. Hastaya torakoskopi planlandý, pariyetal plevrada lokal tümör odaklarý, visseral plevrada kalýnlaþma gözlendi. Biyopsi örneklerinin patoloji ve immün boyama sonuçlarý bifazik malign mezotelyoma olarak raporlandý. Sonuç olarak, malign plevral efüzyon varlýðýnda mezotelyoma olasýlýðý göz ardý edilmemeli ve tanýyý kesinleþtirmek için ayrýntýlý immünohistokimyasal inceleme yapýlmalýdýr.

Anahtar Kelimeler: Genç yaþ, plevral efüzyon, immün boyama, podoplanin, mezotelyoma.

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