Benign papillary mesothelioma of peritoneum: a histological, histochemical and ultrastructural study of six cases

Our plain-English summary of Benign papillary mesothelioma of peritoneum: a histological, histochemical and ultrastructural study of six cases, by J.R. Goepel (Histopathology, 1981).

The study

• Author: J.R. Goepel
• Journal: Histopathology
• Published: 1981;5(1):21-30
• Cited by: 39 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Six cases of localized benign papillary mesothelioma of peritoneum were retrieved from laboratory files over a 20-year period. One presented because of pain following torsion and the remaining five were incidental findings at operation. Light microscopy showed a delicate papillary stroma covered by a single layer of mesothelial cells. The mesothelial cells often showed punctate periodic acid-Schiff staining of cytoplasm. The brush border and stroma showed alcian blue positive staining which was abrogated by prior incubation with hyaluronidase. Electron microscopy revealed typical features of mesothelial cells with long microvilli, rough endoplasmic reticulum in relation to mitochondria, bundles of microfilaments, and tight junctions. Between cells there was a series of intercommunicating channels containing occasional lymphocytes and debris. These features are compared with nodular mesothelial hyperplasia, malignant mesothelioma and adenomatoid tumours of the genital tract. The necessity to distinguish benign papillary mesothelioma from metastatic carcinoma is stressed and relies on the recognition of their mesothelial origin.

In plain English

This case series described six cases of localized benign papillary mesothelioma of the peritoneum (the lining of the abdomen). The cases were found in the laboratory records of two Sheffield hospitals from 1957 to 1977. One patient came in as an emergency with pain after a tumour attached to the stomach had twisted. In four others the tumour was found by chance during abdominal surgery for other problems. Under the microscope, the growths were covered by a single layer of mesothelial cells, with no significant variation in the cells and no dividing cells seen. Electron microscopy, done in two cases, showed tight junctions between cells and channels between cells that sometimes held lymphocytes. No asbestos was seen under either type of microscope, and the author wrote that the patients' occupational histories did not suggest asbestos exposure. Follow-up, where available, showed a benign course. The author concluded that the lesion appears distinctly separate from malignant mesothelioma, but stated it was unclear whether it is a benign tumour or a reactive condition.

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 (histological, histochemical and electron microscopy study of six cases retrieved from laboratory files)
• Who was studied: six patients with peritoneal papillary mesothelioma identified in the laboratory records of the Royal Hospital and Royal Infirmary, Sheffield, 1957 to 1977; equal numbers of men and women; two cases examined by electron microscopy
• Exposure: Asbestos was not the subject of study. No asbestos was seen by light or electron microscopy in the lesions, and the author stated that the occupational histories did not suggest asbestos exposure.
• Main results:
  • One patient presented as an emergency with a gangrenous tumour on the stomach that had undergone torsion (twisting).
  • In four other cases the tumour was found incidentally during abdominal surgery for dyspepsia, dysphagia or intestinal obstruction.
  • Under the light microscope there was no significant nuclear or cellular pleomorphism, and no mitotic figures were seen.
  • PAS staining was punctate in occasional mesothelial cells, but most cells were negative. Alcian blue staining was abolished or much reduced by prior treatment with hyaluronidase.
  • Electron microscopy showed tight junctions between cells and frequent wide gaps between cells forming channels that contained occasional lymphocytes.
  • The cases showed an equal sex incidence, unlike the strong male predominance the author describes for malignant mesothelioma.
  • Follow-up, where available, showed a benign course. The table lists one patient who died at 9 months with no necropsy.
• The authors' conclusion: The author concluded that benign papillary mesothelioma of peritoneum appears distinctly separate from malignant mesothelioma but closely resembles adenomatoid tumours. The author stated it is unclear whether it is a benign neoplasm or a reactive condition, with some grounds for considering it a benign neoplasm.

Topics

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

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Peritoneum, Mesothelial Cells, Reactive Mesothelial Hyperplasia, Malignant Mesothelioma, Adenomatoid Tumor, Carcinoma.

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• Heterozygous loss of NF2 is an early molecular alteration in well-differentiated papillary mesothelioma of the peritoneum — H. Nemoto, G. Tate, et al. (2012)
• Peritoneal malignant mesothelioma versus serous papillary adenocarcinoma. A histochemical and immunohistochemical comparison — D.J. Bollinger, M.R. Wick, et al. (1989)
• Diffuse mesothelioma of the peritoneum: correlation between histological and clinical parameters and survival in 73 patients — S. Liu, P. Staats, et al. (2014)
• Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: a histochemical, ultrastructural, and immunohistologic study of 103 cases — M.R. Wick, T. Loy, et al. (1990)

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