Abstract
Malignant mesothelioma is an insidious neoplasm with dismal prognosis. It exerts its morbidity and mortality via inexorable local invasion. Hematogenous and extrathoracic metastases are unusual. 73-year-old male patient admitted with progressive dyspnea, cough, and fatigue. In past medical history, he was a non-smoker and had diabetes mellitus and hypertension. The patient was dyspneic and cyanotic. There were inspiratory crackles at the lung bases. Rutine laboratory analysis was normal apart from a high erythrocyte sedimentation rate (120 mm/hr), anemia (hb: 10.9 g/dl) and hypoxemia (PaO2: 48 mmHg). Computed tomography revealed multiple mediastinal lymph nodes, bilateral pleural thickenings, paramediastinal mass lesion in the left lower lobe and multiple pulmonary nodules.
Cranial CT was normal. Abdominal USG revealed liver metastasis with multiple hypoechoic nodules 2 cm in diameter. Transbronchial biopsy via fiberoptic bronchoscopy revealed the diagnosis of malignant mesothelioma infiltration. The tumor was diffusely positive for calretinin and focal positive for keratin 5,6. The patient died one week after diagnosis.
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