Pseudomesotheliomatous Adenocarcinoma
Key Facts
Terminology
Malignant epithelial neoplasm of lung origin growing along pleural surface
Etiology/Pathogenesis
Has been linked to the following
Tobacco use
Asbestos exposure
Iron exposure
Stone dust exposure
Clinical Issues
Cough
Shortness of breath
Chest pain
Weight loss
Pleural effusion
Macroscopic Features
Thickening of pleura
Encasement of lung parenchyma
Tumor growth along pulmonary septum
Discrete peripheral intrapulmonary tumor
Microscopic Pathology
Glandular formation
Desmoplastic reaction
Papillary pattern in some cases
Top Differential Diagnoses
Mesothelioma, epithelioid type
Immunohistochemistry: Carcinomatous epitopes positive (CEA-M, TAG72, MOC-31, CD15, TTF-1)
 In this pseudomesotheliomatous adenocarcinoma, note the presence of diffuse pleural thickening  , as well as the presence of distinct intrapulmonary nodules  . |
 Malignant glands are invading fibroconnective tissue of the pleura. Note the presence of malignant cells, some of them showing intracytoplasmic mucin  . |
TERMINOLOGY
Definitions
Malignant epithelial neoplasm of lung origin growing along pleural surface
ETIOLOGY/PATHOGENESIS
Environmental Exposure
Has been linked to the following
Tobacco smoke
Asbestos exposure
Iron exposure
Stone dust exposure
CLINICAL ISSUES
Epidemiology
Incidence
Tumor of rare occurrence
Age
Majority of patients are > 50 years old
Gender
Tumor may be more common in men
Presentation
Cough
Shortness of breath
Chest pain
Weight loss
Pleural effusion
Treatment
Adjuvant therapy
Chemotherapy
Prognosis
Poor with survival of < 18 months
IMAGE FINDINGS
General Features
Tumor mimics radiographic findings of mesothelioma
MACROSCOPIC FEATURES
General Features
Thickening of pleura
Encasement of lung parenchyma
Tumor growth along pulmonary septum
Discrete peripheral intrapulmonary tumor
MICROSCOPIC PATHOLOGY
Histologic Features
Glandular formation
Desmoplastic reaction
Papillary pattern in some cases
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