{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:35:08Z","timestamp":1764603308849},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,3,11]],"date-time":"2015-03-11T00:00:00Z","timestamp":1426032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>A 67\u2010year\u2010old male with a history of asbestos exposure presented with fever, cough, and dyspnea and was found to have diffuse granular shadowing in both lungs, right pleural effusion, and hilar and mediastinal lymphadenopathy upon chest computed tomography. For definitive diagnosis, a thoracoscopic lung biopsy was performed. Intraoperative findings showed no remarkable macroscopic changes in the visceral and parietal pleura, although a high level of hyaluronic acid in the pleural effusion was noted. Histological findings showed proliferation of atypical cells with round\u2010to\u2010oval nuclei, prominent nucleoli, and eosinophilic cytoplasms. These cells were arranged into sheets or tubules and were located predominantly in the lung parenchyma. Lymphovascular invasion was conspicuous. Immunohistochemically, tumor cells were positive for calretinin, <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>2\u201040, and <jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>5\/6, focally positive for <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>er\u2010<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content>4, but negative for <jats:styled-content style=\"fixed-case\">WT<\/jats:styled-content>\u20101, <jats:styled-content style=\"fixed-case\">TTF<\/jats:styled-content>\u20101, <jats:styled-content style=\"fixed-case\">CEA<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">MOC31<\/jats:styled-content>. Fluorescence <jats:italic>in situ<\/jats:italic> hybridization for the tumor suppressor <jats:italic>p16<\/jats:italic> revealed homozygous deletion in the tumor cells. Therefore, we diagnosed the tumor as diffuse intrapulmonary malignant mesothelioma (<jats:styled-content style=\"fixed-case\">DIMM<\/jats:styled-content>). The patient had a poor response to chemotherapy and died 1 year after diagnosis. Although rare, <jats:styled-content style=\"fixed-case\">DIMM<\/jats:styled-content> should be considered when patients present with multiple, tiny intrapulmonary nodules, regardless of macroscopic pleural changes. Furthermore, this is the first report on <jats:italic>p16<\/jats:italic> status in <jats:styled-content style=\"fixed-case\">DIMM<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/pin.12282","type":"journal-article","created":{"date-parts":[[2015,3,11]],"date-time":"2015-03-11T06:23:43Z","timestamp":1426055023000},"page":"318-323","source":"Crossref","is-referenced-by-count":7,"title":["Diffuse intrapulmonary malignant mesothelioma presenting with miliary pulmonary nodules: A case report"],"prefix":"10.1111","volume":"65","author":[{"given":"Tomoyuki","family":"Hida","sequence":"first","affiliation":[{"name":"Department of Pathology Fukuoka University Hospital and School of Medicine  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Hamasaki","sequence":"additional","affiliation":[{"name":"Department of Pathology Fukuoka University Hospital and School of Medicine  Fukuoka 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