Are all adenomatoid tumors adenomatoid mesotheliomas?

Our plain-English summary of Are all adenomatoid tumors adenomatoid mesotheliomas?, by C.L. Davy, C.K. Tang (Human Pathology, 1981).

The study

• Authors: C.L. Davy, C.K. Tang
• Journal: Human Pathology
• Published: 1981;12(4):360-9
• Type of article: Case report
• Cited by: 51 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The ultrastructure of three histologically typical adenomatoid tumors of the epididymis is presented. Two of the three tumors showed morphologic features of mesothelium similar to those reported in the literature. The third tumor demonstrated a multilayered basal lamina and Weibel-Palade bodies, both of which have been found consistently in sclerosing hemangiomas. Although the ultrastructure of the first two tumors confirms the theory of a mesothelial origin of adenomatoid tumors, the findings of the third tumor indicate that a histologically typical adenomatoid tumor may not necessarily be a mesothelioma and that electron microscopy is indispensable in establishing their nature. These findings also lead us to suggest that the term adenomatoid tumor should remain in use for light microscopic diagnosis, and that the term adenomatoid mesothelioma should be applied only when the mesothelial nature of an adenomatoid tumor is proven by electron microscopy. For those that show ultrastructural evidence of endothelial origin, the term adenomatoid angioma seems to be appropriate and accurate. It is possible that the adenomatoid angioma represents a variant of the histiocytoid hemangioma.

In plain English

This article reported three cases of adenomatoid tumor of the epididymis in men aged 46, 60 and 33 who had surgery at the University of Maryland Hospital. Under the ordinary light microscope, all three looked like typical adenomatoid tumors. Under an electron microscope, the first two tumors showed features of mesothelium, including long microvilli (tiny surface projections) and well developed cell junctions. The third tumor differed markedly. It lacked long microvilli. Its cells were surrounded by a multilayered basal lamina, which the authors noted has consistently been found in sclerosing hemangioma, and contained Weibel-Palade bodies, structures found in endothelial cells. The authors stated that electron microscopy confirmed the vascular and endothelial nature of this tumor, and that light microscopy alone could not have revealed it. The authors concluded that a histologically typical adenomatoid tumor may not necessarily be a mesothelioma, and that electron microscopy is indispensable to establish its nature. They proposed keeping the term 'adenomatoid tumor' for light microscopic diagnosis. They would use 'adenomatoid mesothelioma' only when electron microscopy proves mesothelial origin, and 'adenomatoid angioma' for tumors of endothelial origin. The article did not discuss asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series of three patients with light and electron microscopic (ultrastructural) examination of the tumors
• Who was studied: Three men, aged 46, 60 and 33, admitted to the University of Maryland Hospital for surgical removal of an epididymal mass. The dates of the cases are not given.
• Main results:
  • Cases 1 and 2 looked alike under the electron microscope. Their lining cells showed abundant long microvilli, well developed junctions including desmosomes, and a thin basal lamina. The authors described these as typical mesothelial features.
  • In case 3, the long microvilli seen in cases 1 and 2 were not found.
  • In case 3, the basal lamina surrounding the tumor cells was multilayered.
  • The authors noted that a multilayered basal lamina has consistently been found in sclerosing hemangioma, but not in adenomatoid tumors or mesotheliomas.
  • Case 3 contained Weibel-Palade bodies inside the cells. The authors noted that these structures have been found in endothelial cells and in angiosarcoma cells.
  • The authors stated that electron microscopy unequivocally confirmed the vascular and endothelial nature of the cells of the third tumor.
  • The authors stated that, on light microscopy alone, it would have been impossible to interpret the third tumor as an angioma rather than an adenomatoid mesothelioma.
  • The third tumor appeared somewhat similar to the histiocytoid hemangioma.
• The authors' conclusion: The authors said their findings were not evidence against the widely accepted theory that adenomatoid tumors arise from mesothelium. They concluded that a histologically typical adenomatoid tumor may not necessarily be a mesothelioma, and that electron microscopy is indispensable to establish its nature. They proposed using 'adenomatoid mesothelioma' only when electron microscopy proves mesothelial origin. They considered 'adenomatoid angioma' appropriate for tumors that show endothelial origin. They suggested that adenomatoid angioma may be a variant of histiocytoid hemangioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Adenomatoid Tumor, Mesothelioma, Epididymis, Mesothelium.

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