Desmoplastic Malignant Mesothelioma of the Pericardium Mimicking Inflammatory Pericardial Disease: An Autopsy Case Report.

Desmoplastic malignant pericardial mesothelioma is an extremely rare subtype of malignant pericardial mesothelioma that is difficult to distinguish from inflammatory fibrous lesions. A 71-year-old man was admitted with a three-month history of progressive exertional dyspnea and chest tightness. His condition rapidly deteriorated, and he died on hospital day 3. Autopsy revealed bloody pericardial effusion and small epicardial nodules without distinct mass lesions. A histological examination revealed fibrous thickening containing scattered spindle-shaped and stellate atypical cells. The histological and immunohistochemical findings supported this diagnosis. In patients with subacute progressive heart failure of unclear cause, bloody pericardial effusion, or pericardial thickening, this disease should be considered in the differential diagnosis.