doiSerbia

Primary pericardial mesothelioma presenting as constrictive pericarditis

Karadžić Radovan (Institute of Forensic Medicine, Medical Faculty, Niš)
Kostić-Banović Lidija (Institute of Forensic Medicine, Medical Faculty, Niš)
Antović Aleksandra (Institute of Forensic Medicine, Medical Faculty, Niš)
Čelar Marko (Clinic for Surgery, Medical Faculty, Niš)
Katić Vuka V. (Institute for Clinical Pathology, Medical Faculty, Niš)
Ilić Goran (Institute of Forensic Medicine, Medical Faculty, Niš)
Stojanović Jovan (Institute of Forensic Medicine, Medical Faculty, Niš)

Primary pericardial mesothelioma is an extremely rare and lethal cardiac tumor. We report an autopsy case of a primary pericardial mesothelioma in a 52-year-old man. He developed dyspnea, cough, low-grade fever and night sweats approximately 3 months before last admission. Initially, he was evaluated at a hospital in another city, without a firm diagnosis. Due to progressive symptoms and the development of lower-extremity edema, he presented at our hospital in September 2005. The physical examination at admission demonstrated signs of pericardial tamponade. Chest radiography revealed marked enlargement of the cardiac silhouette. Specimens of bloody pericardial fluid were positive for pericardial mesothelioma by cytologic examination. The general condition of the patient worsened very rapidly and he was transferred to the intensive care unit where he later died. Postmortem examination confirmed primary pericardial mesothelioma of the mixed/biphasic type with lymphatic metastasis in the right lung. By using immunohistochemical analysis for specific markers of mesothelioma and for differentiation of the mesothelioma from the lung adenocarcinoma, definitive diagnosis was established: primary pericardial mesothelioma.

Keywords: pericardium, mesothelioma, pericarditis, constrictive, diagnosis, autopsy, immunohistochemistry, cytology