College of American Pathologists

2014 — June Case of the Month

Posted June 24, 2014


CAP Foundation Online Case of the Month

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A 72-year-old man presented with gradually worsening shortness of breath and was noted to have a large left pleural effusion. CT scan confirmed the presence of the left-sided effusion and additionally revealed a diffusely thickened, nodular pleura surrounding most of the left lung. A pulmonary intraparenchymal mass was not present. The patient expired prior to completion of the medical workup. The tissue provided is from the autopsy, which confirmed the presence of tumor diffusely involving the left pleura and no malignancy elsewhere. Immunohistochemical stains demonstrated a pan-cytokeratin (+), calretinin (+), WT-1(+), CK 5/6 (+), D2-40 (+), CEA (-), Leu-M1 (-), MOC-31 (-), TTF-1 (-) profile.

The master list with the correct answer

  • Adenocarcinoma
  • Angiosarcoma, epithelioid type
  • Epithelioid hemangioendothelioma
  • Large cell lymphoma
  • Malignant mesothelioma
  • Metastatic melanoma

Access Case Critique to view:

  • Appropriate diagnosis
  • Critique
  • References

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