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We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy. CT also showed a consolidative mass with bronchovascular bundle and septal thickening in the lungs suggesting pulmonary parenchymal involvement and the lymphangitic spread of the tumor. These CT findings mimicked lung cancer with pleuritis and lymphangitic carcinomatosis. Autopsy was performed in both cases. Macroscopically, the tumor cells infiltrated the lung with the marked lymphatic spread of the tumor. Microscopy also revealed that the tumor had invaded the pulmonary parenchyma with the marked lymphatic spread of the tumor. Although this growth pattern is unusual, malignant pleural mesothelioma should be considered as the differential diagnosis, especially in patients with pleural lesions.

Background In order to be able to take preventative measures early in life against the development of atherosclerosis, it is important to evaluate profiles of subclinical atherosclerosis, especially among young adults. Methods We screened plasma homocysteine levels, highly sensitive C-reactive protein levels and carotid intima-media thickness in young and elderly adults. Results Among both young and elderly adults, plasma homocysteine and highly sensitive C-reactive protein were significantly lower in females than in males. Highly sensitive C-reactive protein was significantly lower in young adults than in elderly adults, and homocysteine was lower (but not significantly) in young adults than in elderly adults. Among young adults, mean carotid intima-media thickness was lower (but not significantly) in females than in males. Among elderly adults, mean carotid intima-media thickness was significantly lower in females than in males. Among both males and females, mean carotid intima-media thickness was significantly higher in elderly adults than in young adults. Conclusions These results demonstrate basic profiles of atherosclerosis markers in young and elderly Japanese adults. Further study is needed to evaluate measures developed for application in early adulthood to prevent atherosclerosis.