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Paliogiannis P, Putzu C, Ginesu GC, Cossu ML, Feo CF, Attene F, Scognamillo F, Nonnis R, Cossu A, Palmieri G, Pirina P, Fois A. Deciduoid mesothelioma of the thorax: A comprehensive review of the scientific literature. CLINICAL RESPIRATORY JOURNAL 2017; 12:848-856. [PMID: 28026144 DOI: 10.1111/crj.12599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/25/2016] [Accepted: 12/20/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Deciduoid mesothelioma is a rare variant of malignant epithelioid mesothelioma. It often involves the peritoneum, but also thoracic cases have been reported. The aim of the present review is to describe the demographic, clinical, radiological, and pathological features of such a rare variant of thoracic mesothelioma, and the state of the art regarding the therapeutic approaches currently available. DATA SOURCE English-language articles published from 1985 to June 2016, and related to thoracic deciduoid mesothelioma cases were retrieved using the Pubmed database. STUDY SELECTION The search terms were "mesothelioma," "thoracic mesothelioma," "epithelial mesothelioma," "pleural mesothelioma," and "deciduoid mesothelioma." RESULTS Forty-four cases included in 16 articles, published in the period under investigation, were analyzed in detail. CONCLUSIONS The mean age of the patients was 63 years, and the male to female ratio 1.7:1. Approximately 58% had exposure to asbestos, and 73% had a smoking history; familiarity was rarely reported. The most common anatomical site of origin was the right pleura, and the most frequent clinical manifestations were chest pain, dyspnea, cough, and weight loss. Thoracic X-ray and computed tomography were the imaging techniques most employed for diagnosis and surgical planning. The pathological diagnosis was obtained by examination of surgical or biopsy specimens in most cases. The best treatment strategy of deciduoid mesothelioma is a matter of debate; nevertheless a multidisciplinary approach is currently the best option for the choice of the adequate therapeutic scheme.
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Affiliation(s)
- Panagiotis Paliogiannis
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Carlo Putzu
- Oncology Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Giorgio Carlo Ginesu
- Surgical Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Maria Laura Cossu
- Surgical Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Claudio Francesco Feo
- Surgical Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100, Sassari, Italy
| | - Federico Attene
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Fabrizio Scognamillo
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Rita Nonnis
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Antonio Cossu
- Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, Sassari, 07100, Italy
| | - Giuseppe Palmieri
- Institute of Biomolecular Chemistry, Cancer Genetics Unit, C.N.R, Traversa La Crucca 3, Sassari, 07040, Italy
| | - Pietro Pirina
- Pulmonology Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Vle V.le San Pietro 43, Sassari 07100, Italy
| | - Alessandro Fois
- Pulmonology Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Vle V.le San Pietro 43, Sassari 07100, Italy
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Morini M, Bettini G, Morandi F, Burdisso R, Marcato PS. Deciduoid Peritoneal Mesothelioma in a Dog. Vet Pathol 2016; 43:198-201. [PMID: 16537940 DOI: 10.1354/vp.43-2-198] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Deciduoid mesothelioma is a rare variant of epithelial mesothelioma, up to now only described in human pathology, which bears remarkable cytomorphologic resemblance to the endometrium of pregnancy, termed decidua. A case of peritoneal mesothelioma with deciduoid features in a 10-year-old, female dog is reported. Multiple whitish-gray nodules (1-5 mm in diameter) in parietal peritoneum and mesentery were histologically composed of large, proliferating, polygonal or ovoid cells with an abundant eosinophilic, glassy cytoplasm. Immunohistochemical evaluation indicated that the neoplastic cells coexpressed cytokeratin and vimentin with strong and diffuse cytoplasmic staining, and ultrastructural analysis showed long and slender mesothelial-type microvilli; these findings confirmed the mesothelial origin of the tumor.
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Affiliation(s)
- M Morini
- Dipartimento di Sanità Pubblica Veterinaria e Patologia Animale, Servizio di Anatomia Patologica, Università degli Studi di Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia, Bologna, Italy
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Abstract
Deciduoid mesothelioma is a rare variant of epithelioid mesothelioma that was initially considered to occur exclusively in the peritoneum of young women who had no history of asbestos exposure and to be characterized by an aggressive clinical course, but it was later demonstrated that this tumor could also occur in the pleura of older men and women who had been exposed to asbestos. Some subsequent studies have also indicated that the clinical course is no different from that of conventional epithelioid mesothelioma. Herein are reported 21 cases of deciduoid mesothelioma that were investigated using a large panel of immunohistochemical markers, 9 of which were also studied by electron microscopy. Fifteen of the patients were male and 6 were female (mean age, 60 years). Seventeen of the cases originated in the pleura and four in the peritoneum. Histologically, all of the cases were composed of large, polygonal or ovoid cells with well-defined cell borders, dense eosinophilic cytoplasm, and single or multiple nuclei. In some cases, the cells exhibited a wide variation in their size and shape, frequent loss of cell cohesion, marked nuclear atypia, and high mitotic activity (>5 per 10 HPF); whereas, in others, the cells were more cohesive, less pleomorphic, and the mitotic activity low. As the survival of patients in the first group of cases was shorter (mean, 7 months), when compared with that of the latter (mean, 23 months), it is concluded that the differences in prognosis reported in deciduoid mesothelioma are due to the existence of a high-grade subgroup that presents highly aggressive clinical behavior. Therefore, when a high-grade deciduoid mesothelioma is present, it should be reported as it can significantly affect prognosis and treatment. The use of immunohistochemistry and electron microscopy in assisting in the differential diagnosis of deciduoid mesothelioma is also discussed.
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Huang CC, Michael CW. Deciduoid mesothelioma: Cytologic presentation and diagnostic pitfalls. Diagn Cytopathol 2012; 41:629-35. [DOI: 10.1002/dc.22902] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 06/24/2012] [Indexed: 11/08/2022]
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La déciduose ectopique : variabilités de présentation pendant la grossesse et diagnostics différentiels. ACTA ACUST UNITED AC 2012; 40:235-40. [DOI: 10.1016/j.gyobfe.2012.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 02/20/2012] [Indexed: 11/22/2022]
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Santos C, Gamboa F, Fradinho F, Pêgo A, Carvalho L, Bernardo J. Deciduoid pleural mesothelioma--a rare entity in a young woman. REVISTA PORTUGUESA DE PNEUMOLOGIA 2012; 18:294-8. [PMID: 22424699 DOI: 10.1016/j.rppneu.2012.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 12/16/2011] [Indexed: 11/30/2022] Open
Abstract
Deciduoid Mesothelioma is a rare variant of epithelioid mesothelioma; it was initially thought that it only occurred in the peritoneum of young women and had nothing to do with asbestos exposure. However, since these early findings it has also been observed in the pleura and the pericardium, with possible association to asbestos. In general the prognosis is poor compared to epithelioid mesothelioma. 45 cases have been reported in the literature up to now, 22 of these were located in the pleural cavity. The authors describe a case of deciduoid pleural mesothelioma in a 40-year-old-woman who presented with right pleuritic chest pain, with no history of asbestos exposure, treated with chemotherapy followed by surgery and who died postoperatively.
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Affiliation(s)
- C Santos
- Serviço de Pneumologia, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
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Soltermann A, Pache JC, Vogt P. Metastasis of a pleural mesothelioma to a hyperplastic stomach polyp: an increase of vimentin expression is seen during a gain in deciduoid morphology. Rare Tumors 2011; 3:e52. [PMID: 22355507 PMCID: PMC3282457 DOI: 10.4081/rt.2011.e52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 06/07/2011] [Accepted: 10/25/2011] [Indexed: 11/24/2022] Open
Abstract
Deciduoid mesothelioma is a rare variant of the epithelioid histotype spectrum, resembling decidua of gravid uterus. It is found in the peritoneum of young women, but also in the pleura of elderly people. Histotype plasticity from epithelioid to sarcomatoid mesothelioma may be considered as epithelial-mesenchymal transition (EMT). A full autopsy was performed and mesothelioma infiltrates were analysed by immunohistochemistry. The metastasis of an epithelioid pleural mesothelioma to a hyperplastic polyp of the stomach is presented in this autopsy case. Deciduoid morphology increased during tumour progression and metastasis. The increase in eosinophilic cytoplasm correlated with the upregulation of the intermediate filament vimentin. High expression of vimentin was found in both central and superficial periglandular regions of the polyp. High vimentin expression also can occur in epithelioid rather than sarcomatoid differentiation. Thus, although vimentin is considered to be the major EMT marker, additional pathways must regulate its expression.
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Affiliation(s)
- Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich, Zurich
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Val-Bernal JF, Val D, Gómez-Aguado F, Corcuera MT, Garijo MF. Hypodermal Decidualized Endometrioma With Aberrant Cytokeratin Expression. A Lesion Mimicking Malignancy. Am J Dermatopathol 2011; 33:e58-62. [DOI: 10.1097/dad.0b013e3181f704f6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ustun H, Astarci HM, Sungu N, Ozdemir A, Ekinci C. Primary malignant deciduoid peritoneal mesothelioma: a report of the cytohistological and immunohistochemical appearances. Diagn Cytopathol 2010; 39:402-8. [PMID: 21574260 DOI: 10.1002/dc.21400] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 03/05/2010] [Indexed: 11/06/2022]
Abstract
Malignant deciduoid mesothelioma (MDM) is a rare variant of epithelioid mesothelioma. This type of tumor might be associated with the asbestos exposure and carries a poor prognosis in general. MDM was first described by Nascimento et al. in 1994 in a peritoneal lesion of a young woman. And its diagnosis is frequently mistaken with florid mesothelial hyperplasia and peritoneal deciduosis. There are 44 MDM cases reported in the literature up today. A 59-year-old woman patient referred to our clinic was identified with an abdominal mass. Computed tomography of whole abdomen of the patient showed a mass with the widest transverse dimension of 65 × 60 mm at abdominal bifurcation in the mesenteric region. The patient was diagnosed with MDM after the cytopathological examination of the fine needle aspiration biopsy performed from the mass. Consequently, she received a total mass excision and right hemicolectomy under general anesthesia. The cytomorphological appearance of the ascitic fluid is detailed for the first time by Gillespie et al. and is described only in two manuscripts. In the present study, we aimed to report a case of a 59-year-old woman since she was diagnosed with MDM and because her cytological findings were further supported by histomorphological and immunohistochemical evaluations of the operation material obtained from the patient.
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Affiliation(s)
- Huseyin Ustun
- Department of Pathology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
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Tsai LY, Yang YL, Lu MY, Lin DT, Huang HY, Lin KH. Deciduoid mesothelioma of the pleura in an adolescent boy. Pediatr Hematol Oncol 2010; 27:132-7. [PMID: 20201694 DOI: 10.3109/08880010903447359] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Deciduoid mesothelioma is an extremely rare variant of malignant epithelioid mesothelioma. This report presents the case of a 13-year-old boy with this type of tumor in his pleura, whose initial main symptoms were chest pains and progressive scoliosis. Ensuing chemotherapy, which comprised pemetrexed and cisplatin, yielded good response after 5 cycles. Subsequent radical surgery was carried out and another 3 cycles of chemotherapy were given. The patient has been doing well 2 years after completion of this regime of treatment.
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Affiliation(s)
- Li-Yi Tsai
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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12
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Abstract
Many centres are now seeing increasing numbers of patients with malignant mesothelioma. This presents pathologists involved in making the diagnosis with a number of problems, which can be divided into those encountered in making the distinction between mesothelioma and benign changes and those experienced in separating mesotheliomas from other types of epithelial and connective tissue tumours. Immunohistochemistry plays a major role in helping to make the diagnosis, but it should be interpreted with due regard to the clinical setting and radiological features, and with a knowledge of the wide morphological variations seen in mesothelioma. This review identifies some of these problems and addresses the uses and limitations of immunohistochemistry in different situations. It includes a discussion of some of the less common variants of mesothelioma and other pleural-based tumours that enter into the differential diagnosis.
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Affiliation(s)
- Bruce Addis
- Department of Cellular Pathology, Southampton University Hospitals NHS Trust, Southampton, UK.
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Demirag F, Unsal E, Tastepe I. Biphasic malignant mesothelioma cases with osseous differentiation and long survival: a review of the literature. Lung Cancer 2007; 57:233-6. [PMID: 17363104 DOI: 10.1016/j.lungcan.2007.01.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Revised: 01/14/2007] [Accepted: 01/30/2007] [Indexed: 01/12/2023]
Abstract
This report describes two cases of diffuse biphasic malignant mesothelioma with osseous differentiation and long survival. Two male patients aged 66 and 54 years presented with chest pain, bloody pleural effusions, and diffuse and nodular pleural thickening. They both had a history of prolonged asbestos exposure. Sarcomatoid and epithelioid areas were identified on histopathological examination. In addition, there were foci of ossification. Epithelioid tumor cells as well as benign osteoclasts within the ossification reacted positively for cytokeratin 5/6, whereas sarcomatoid areas were negative. Both patients survived 39 and 69 months, respectively. To our knowledge, these two cases with biphasic malignant mesothelioma and osseous differentiation with long survival are the first to be described from Central Anatolia.
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Affiliation(s)
- Funda Demirag
- Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Department of Pathology, Ankara, Turkey
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Ordóñez NG. Pathologic characterization and differential diagnosis of malignant peritoneal mesothelioma. Recent Results Cancer Res 2007; 169:123-36. [PMID: 17506256 DOI: 10.1007/978-3-540-30760-0_12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Nelson G Ordóñez
- The University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA
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Scattone A, Pennella A, Gentile M, Musti M, Nazzaro P, Buonadonna AL, Marzullo A, Cavone D, Pollice L, Serio G. Comparative genomic hybridisation in malignant deciduoid mesothelioma. J Clin Pathol 2006; 59:764-9. [PMID: 16569690 PMCID: PMC1860431 DOI: 10.1136/jcp.2005.026435] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2005] [Indexed: 11/04/2022]
Abstract
BACKGROUND Malignant deciduoid mesothelioma is a rare variant of epithelioid mesothelioma. This tumour generally has poor prognosis, and can be asbestos related. AIM To identify peculiar genetic changes responsible for critical phases in pathogenesis of malignant deciduoid mesothelioma and their prognostic relevance. METHODS Comparative genomic hybridisation was carried out in six cases of malignant pleural deciduoid mesothelioma, four sporadic and two familial. All cases were found to be asbestos related. Four patients died during follow-up and the mean survival was 29.5 (SD 14.2, range 12-43) months. RESULTS Genetic abnormalities were found in all the tumour tissues, the most frequent being chromosomal gains at 1p, 12q, 17, 8q, 19 and 20 and losses at 13q, 6q and 9p. Survival was found to be longer in those patients who presented a smaller number of losses (< or =2) in the tumorous chromosomes. CONCLUSIONS Although numerous genetic changes are presented by deciduoid mesotheliomas, certain chromosomal regions are preferentially affected. The clinical outcome for this mesothelioma subtype is predicted by the number of losses.
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Affiliation(s)
- A Scattone
- Department of Pathology, Medical School, University of Bari, Italy
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Allen TC. Recognition of Histopathologic Patterns of Diffuse Malignant Mesothelioma in Differential Diagnosis of Pleural Biopsies. Arch Pathol Lab Med 2005; 129:1415-20. [PMID: 16253022 DOI: 10.5858/2005-129-1415-rohpod] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractContext.—Diffuse malignant mesothelioma is generally divided into 3 basic histologic types—epithelial, biphasic, or sarcomatous. However, a great diversity of histologic patterns exists within these 3 basic histologic types.Design.—The diverse histologic patterns of diffuse malignant mesothelioma are briefly described, including infrequently encountered patterns.Results. The histologic patterns of diffuse malignant mesothelioma provide a wide variation of features for the pathologist to consider in the differential diagnosis of a pleural biopsy.Conclusion.—Pathologists should be aware of the varied histologic patterns of diffuse malignant mesothelioma when evaluating pleural biopsies.
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Affiliation(s)
- Timothy Craig Allen
- Department of Pathology, The University of Texas Health Center, Tyler, TX 75708, USA.
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Mourra N, de Chaisemartin C, Goubin-Versini I, Parc R, Flejou JF. Malignant deciduoid mesothelioma: a diagnostic challenge. Arch Pathol Lab Med 2005; 129:403-6. [PMID: 15737040 DOI: 10.5858/2005-129-403-mdmadc] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Malignant deciduoid mesothelioma, a rare phenotype of epithelioid mesothelioma, arises more commonly from the peritoneum of young women, but it is also reported in the pleura of elderly people. We report a case of malignant deciduoid mesothelioma that occurred in a 41-year-old woman after cesarean section and was initially misdiagnosed as pseudotumoral deciduosis. Microscopically, the tumor was entirely composed of deciduoid areas, and only scattered tumor cells were positive for calretinin and keratin 5/6. The patient died 14 months after the first operation. This observation confirms the poor prognosis of this entity and the importance of the differential diagnosis of pseudotumoral deciduosis.
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Affiliation(s)
- Najat Mourra
- Department of Pathology, Hôpital St-Antoine, Paris, France.
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Kimura N, Ogasawara T, Asonuma S, Hama H, Sawai T, Toyota T. Granulocyte-colony stimulating factor- and interleukin 6-producing diffuse deciduoid peritoneal mesothelioma. Mod Pathol 2005; 18:446-50. [PMID: 15309018 DOI: 10.1038/modpathol.3800245] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An autopsy case of granulocyte colony-stimulating factor (G-CSF)- and interleukin-6 (IL-6)-producing diffuse deciduoid peritoneal mesothelioma is reported. The patient was a 70-year-old man with abdominal distension and weight loss in the year prior to his death. Laboratory data suggested severe inflammation with marked leukocytosis, thrombocytosis and elevated serum levels of C-reactive protein, G-CSF and IL-6. Imaging studies showed an expansive mass occupying the entire abdomen and pelvic cavity. Histological diagnosis of tissue taken by needle biopsy was difficult due to the unusual sarcomatoid-appearance of the tumor. In addition, there was severe infiltration of numerous neutrophilic leukocytes. An autopsy revealed that the diffuse peritoneal tumor had a fresh fishmeat-like appearance with focal mucinous degeneration and entirely encased the abdominal organs. Histological examination showed a sheet-like proliferation of tumor cells with large ovoid or polygonal cytoplasm, large atypical nuclei and obvious nucleoli. The tumor cells showed abundant glycogen and hyaluronic acid, and were immunoreactive to cytokeratin, calretinin, epithelial membrane antigen (EMA), CA-125, and focally to vimentin. The tumor cells were immunoreactive to G-CSF and IL-6. Electron microscopy revealed long, slender microvilli on the tumor cell surface. This tumor was diagnosed as a G-CSF- and IL-6-producing, diffuse deciduoid mesothelioma. We report this case with special reference to the differential diagnosis of deciduoid peritoneal mesothelioma with paraneoplastic syndrome.
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Affiliation(s)
- Noriko Kimura
- Department of Pathology and Laboratory Medicine, Tohoku Rosai Hospital, Sendai, Japan.
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Serio G, Scattone A, Gentile M, Nazzaro P, Pennella A, Buonadonna AL, Pollice L, Musti M. Familial pleural mesothelioma with environmental asbestos exposure: losses of DNA sequences by comparative genomic hybridization (CGH). Histopathology 2004; 45:643-5. [PMID: 15569059 DOI: 10.1111/j.1365-2559.2004.01941.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maeda S, Hosone M, Katayama H, Azuma K, Yokota A, Nakai A, Liu A, Naito Z. Deciduoid mesothelioma in the pelvic cavity. Pathol Int 2004; 54:67-72. [PMID: 14674999 DOI: 10.1046/j.1440-1827.2003.01588.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A very rare case of deciduoid mesothelioma in the pelvic cavity is presented. A 24-year-old woman (gestational stage: 28 weeks and 6 days) was admitted because of a tumor mass in the abdominal cavity. A well-circumscribed and fibrously encapsulated tumor mass was revealed in the Douglas cavity. Histologically, tumor cells were arranged in a solid sheet with deciduoid appearance and showed partial glandular and papillary structures. The tumor cells contained PAS positive and diastase-digested granules in the cytoplasm as well as alcian-blue positive and hyaluronidase-digested substances in the stroma. The cellularity of the tumor cells was moderate and mitoses were rare. There was partial tumor necrosis and tumor cells had infiltrated through the fibrous capsule. Immunohistochemically, the tumor cells were reactive for pancytokeratin, cytokeratin5/6, vimentin, HBME-1, calretinin and thrombomodulin. Ultrastructurally, numerous, long microvilli, tonofilaments and desmosome junctions could be seen. Consequently, this case was diagnosed as deciduoid mesothelioma and 2 years and 4 months after operation, the patient's clinical course has been good. This case is considered to be the first reported in Japan.
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Affiliation(s)
- Shotaro Maeda
- Department of Pathology, Nippon-Medical School, Tama-Nagayama Hospital, Tokyo, Japan.
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