SMALL-CELL CARCINOMA OF LUNG SIMULATING PLEURAL MESOTHELIOMA - REPORTOF 4 CASES WITH AUTOPSY CONFIRMATION

Four cases of small cell carcinoma characterized by a striking involve ment of the pleural sheets were investigated. The patients, four admit males with a long history of cigarette smoking, presented with sympto ms common to pleural tumors, including cough and chest pain. Malignant cells were identified in pleural effusions of all cases and in the br onchial aspirate of one patient. Antitumoral treatments included chemo - and/or radiotherapy. Survival ranged from three to 17 months. At aut opsy, the serosal sheets resulted to be extensively involved by thick tumor rinds, associated with massive hilar metastases. Histologically, the tumors were composed of small epithelial cells, expressing carcin oembryonic antigen and keratins and occasionally neuroendocrine marker s. Our findings indicate that small cell carcinoma should be added to the group of pseudomesotheliomatous lung carcinomas and, above all, th at it deserves distinction from ordinary mesothelioma, especially the small cell variant, because of its medico-legal implications and possi ble antitumoral treatment.