Abstract
Systemic lymph node metastasis is a rare event in malignant mesothelioma. It is even more exceptional when systemic lymph node metastasis is the initial clinical presentation. Review of literature discloses only four cases in which metastatic lymphadenopathy was the only symptom of malignant mesothelioma. We, herewith, report three cases where the initial diagnosis of malignant mesothelioma was made by biopsy of enlarged lymph nodes, which were the only clinical presentation. Immunohistochemistry played a pivotal role in elucidating the mesothelial origin of their unusual systemic lymph node metastasis.
Highlights
Malignant mesothelioma (MM) is an uncommon neoplasm which is characterized by highly aggressive behavior and poor prognosis [1]
We describe three additional cases of primary peritoneal MM in which the initial diagnosis of the disease was made by biopsy of neck, supraclavicular lymph nodes, and axillary lymph nodes
Two cases were primary from peritoneum and the third originated in the pleura
Summary
Malignant mesothelioma (MM) is an uncommon neoplasm which is characterized by highly aggressive behavior and poor prognosis [1]. The neoplasm predominantly involves pleural and peritoneal cavities, with a smaller percentage of cases arising in the pericardial sac and testicular tunica vaginalis [2]. The majority of patients have local symptoms such as chest or abdominal pain and dyspnea, depending on the site of origin. Systemic lymphadenopathy is an exceeding rare initial presentation of this disease [3]; thirteen cases have been reported in literature. Systemic lymphadenopathy was the only clinical manifestation [4,5,6]. We describe three additional cases of primary peritoneal MM in which the initial diagnosis of the disease was made by biopsy of neck, supraclavicular lymph nodes, and axillary lymph nodes. Two cases were primary from peritoneum and the third originated in the pleura
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