Adenocarcinoma simulating mesothelioma

Our plain-English summary of Adenocarcinoma simulating mesothelioma, by B. Corrin, A. Dewar (Ultrastructural Pathology, 1996).

The study

• Authors: B. Corrin, A. Dewar
• Journal: Ultrastructural Pathology
• Published: 1996;20(4):327-9
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pleural biopsy in a 45-year-old woman with a haemorrhagic pleural effusion showed malignant cells. Stains for mucin and carcinoembryonic antigen were positive and adenocarcinoma was diagnosed. Some ultrastructural features were more typical of mesothelioma.

In plain English

This short article was a case report by authors at the Royal Brompton Hospital in London, followed by a brief comment on the authors' electron microscopy findings in other adenocarcinomas. A 45-year-old woman with breathlessness had a bloody fluid collection around the lung (a haemorrhagic pleural effusion). Her pleural biopsy showed cancer cells that could have been either adenocarcinoma or mesothelioma. Stains for mucin and for carcinoembryonic antigen were positive, and this indicated adenocarcinoma rather than mesothelioma. Under the electron microscope, the tumor also showed long, curly microvilli in close contact with collagen bundles. The authors described these features as more typical of mesothelioma. In a 1987 report, the authors had found microvillus and collagen contact in 10 of 12 mesotheliomas and 0 of 20 adenocarcinomas. In this article they reported examining 157 adenocarcinomas by electron microscopy. Of these, 12 (8%) had long, curly microvilli and 10 (6%) had microvillus and collagen contact. The authors concluded that either feature favors mesothelioma but neither is specific. The article does not mention asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report with a brief comment that included the authors' electron microscopy findings in 157 adenocarcinomas
• Who was studied: One 45-year-old woman with a haemorrhagic pleural effusion (authors at the Royal Brompton Hospital, London), plus 157 adenocarcinomas examined by electron microscopy. The time period and how the 157 cases were selected are not stated.
• Main results:
  • In the woman's pleural biopsy, periodic acid-Schiff staining for epithelial mucin and immunostaining for carcinoembryonic antigen were positive, indicating carcinoma rather than mesothelioma
  • Electron microscopy of the woman's tumor showed mucus granules and long, curly microvilli in close contact with collagen bundles
  • Among 157 adenocarcinomas examined by electron microscopy, long, curly microvilli were found in 12 (8%) and microvillus/collagen contact in 10 (6%)
  • Of the 12 adenocarcinomas with long, curly microvilli, 10 were intrapulmonary tumors and 2 were pleural deposits. All showed Clara cell (7), mucous (3) or both (2) types of differentiation.
  • Of the 10 adenocarcinomas with microvillus/collagen contact, 4 were intrapulmonary tumors, 3 were lymph node metastases and 3 were pleural deposits. All showed Clara cell (1), mucous (8) or both (1) types of differentiation.
• The authors' conclusion: The authors concluded that the tumor was an adenocarcinoma showing some ultrastructural features more typical of mesothelioma. They now regard long, curly microvilli or microvillus/collagen contact as favoring mesothelioma, but neither as specific.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Adenocarcinoma, Mesothelioma, Pleural Biopsy, Pleural Effusion, Carcinoembryonic Antigen (CEA).

Related studies

• Adenocarcinoma simulating mesothelioma: a clinicopathologic and immunohistochemical study of 29 cases — M.N. Koss, M. Fleming, et al. (1998)
• Claudin-4 immunohistochemistry is highly effective in distinguishing adenocarcinoma from malignant mesothelioma in effusion cytology — V.Y. Jo, E.S. Cibas, et al. (2014)
• Cytological differential diagnosis among adenocarcinoma, epithelial mesothelioma, and reactive mesothelial cells in serous effusions by immunocytochemistry — X.Y. Su, G.D. Li, et al. (2011)
• The diagnostic utility of D2-40, calretinin, CK5/6, desmin and MOC-31 in the differentiation of mesothelioma from adenocarcinoma in pleural effusion cytology — T.S. Hyun, M. Barnes, et al. (2012)
• Diagnostic efficacy of electron microscopy and pleural effusion cytology for the distinction of pleural mesothelioma and lung adenocarcinoma — H. Domínguez-Malagón, A.M. Cano-Valdez, et al. (2016)
• Ber-EP4 for differentiating adenocarcinoma from reactive and neoplastic mesothelial cells in serous effusions. Comparison with carcinoembryonic antigen, B72.3 and Leu-M1 — M.E. Bailey, R.W. Brown, et al. (1996)

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