Sudden cardiac death due to primary malignant pericardial mesothelioma: Brief report and literature review

Abstract

Sudden cardiac death is an unexpected clinical condition that typically occurs due to a cardiac cause, generally within 1 h of symptom onset, in people with known or unknown cardiac disease. Primary malignant pericardial mesothelioma, as a cause of sudden death, is an uncommon consequence of a rare disease. Herein, we present a case of cardiac tamponade due to a primary pericardial mesothelioma. Cytological, histopathology and gross post-mortem findings, in a previously asymptomatic 46-old-year man, are reported. The medical literature regarding this topic is also reviewed.

Keywords: Cardiac tamponade; Cytological; Histopathology and gross post-mortem findings; Primary malignant pericardial mesothelioma; Sudden cardiac death.

Fig. 1

Gross appearance of the thickened pericardium showing irregular and granular surfaces with necrotic foci.

Fig. 2

A: PMPM epithelioid type (H x E, x 200). B: Tumoral positivity for calretinin (PAP-Diaminobenzidine immunostain, x 400).

Fig. 3

Pericardial fluid cytology. A: large irregular cluster of malignant mesothelial cells in a haemorrhagic background (Papanicolaou stain, x 400). B: mesothelial malignant cells showing increased N:C ratios, pleomorphism, coarse chromatin, and prominent nucleoli (Papanicolaou stain, x 400). C: calretinin positivity of these malignant mesothelial cells (PAP-Diaminobenzidine immunostain, x 400).