Mesothelioma with a Large Prevascular Lymph Node: N1 Involvement or Something Different?
The Annals of Thoracic Surgery 2018 January 18 [Epub ahead of print] [Link]
Berzenji L, Van Schil PE, Snoeckx A, Hertoghs M, Carp L
A 64-year-old man presented with a large amount of right-sided pleural fluid upon imaging, together with calcified pleural plaques and an enlarged nodular structure in the prevascular mediastinum, presumably an enlarged lymph node. Pleural biopsies were obtained during video-assisted thoracoscopic surgery to exclude malignancy. Histopathology showed an epithelial malignant pleural mesothelioma. Induction chemotherapy with cisplatin/pemetrexed was administered followed by an extended pleurectomy/decortication with systematic nodal dissection. Histopathology confirmed the diagnosis of a ypT3N0M0 (stage IB) mesothelioma and an unexpected thymoma type B2 (stage II) was discovered in the prevascular nodule. Simultaneous occurrence of a mesothelioma and thymoma is extremely rare.