Deciduoid peritoneal mesothelioma. A report of the cytological appearances

Our plain-English summary of Deciduoid peritoneal mesothelioma. A report of the cytological appearances, by F.R. Gillespie, J.D. van der Walt, N. Derias, et al (Cytopathology, 2001).

The study

• Authors: F.R. Gillespie, J.D. van der Walt, N. Derias, A. Kenney
• Journal: Cytopathology
• Published: 2001;12(1):57-61
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors (Guy's and St Thomas' Hospitals, London) reported a case of deciduoid malignant mesothelioma of the peritoneum. This variant had previously been described in young females unexposed to asbestos. They described, for the first time, the cytological appearances of the ascitic fluid. A 50-year-old woman presented with a 5-month history of generalized abdominal pain and occasional episodes of rectal bleeding. At laparoscopy, 300 mL of straw-coloured fluid was aspirated. At laparotomy, 500 mL of ascites and an inflamed, indurated omentum were found, and the omentum, both ovaries and both tubes were removed. Ascitic fluid cytology and the intraoperative frozen section were initially considered to show reactive mesothelial proliferation. Examination of the omental mass, including immunocytochemistry and electron microscopy, established a diagnosis of deciduoid malignant mesothelioma. Small numbers of malignant cells were found on the surface of the ovaries and tubes. The fluid contained a single population of large, rounded mesothelial cells with abundant dense cytoplasm, prominent nucleoli and slightly coarser chromatin, with a background of inflammatory cells. The authors noted that the patient fell within the usual age group for malignant mesothelioma and had no history of asbestos exposure. She was referred for chemotherapy and remained well over a year later. They concluded that peritoneal mesothelioma in non-asbestos-exposed females of a wide age range must be borne in mind in the differential diagnosis of ascitic fluid cytopathology.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This case report described a 50-year-old woman, treated at a London hospital, with deciduoid malignant mesothelioma of the peritoneum (the lining of the abdomen), an unusual form of the disease. The article reported no history of asbestos exposure. The patient had five months of abdominal pain. Surgery found straw-coloured fluid in the abdomen and an inflamed mass in the omentum, which was removed. Cells in the abdominal fluid, and a rapid frozen section taken during surgery, were at first interpreted as reactive (non-cancerous) mesothelial cells. Full examination of the omental mass, including antibody staining and electron microscopy, established the diagnosis. The authors described, for the first time, how this tumour looks in fluid samples: large rounded cells with abundant dense cytoplasm and prominent nucleoli, with inflammatory cells in the background. Small numbers of malignant cells were also found on the surface of the ovaries and Fallopian tubes. The patient was referred for chemotherapy and remained well over a year later. The authors concluded that peritoneal mesothelioma should be considered in women without asbestos exposure across a wide age range. They noted that too few cases have been recorded to establish a prognosis.

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 report (single patient), describing the cytological appearances of abdominal fluid
• Who was studied: One 50-year-old woman seen at Guy's and St Thomas' Hospitals, London, UK, with a 5-month history of generalized abdominal pain
• Exposure: No history of asbestos exposure was reported for this patient; no fiber type or occupation is described
• Main results:
  • The abdominal fluid cytology and the intraoperative frozen section were initially interpreted as reactive mesothelium, not cancer
  • Examination of the removed omental mass established a diagnosis of deciduoid malignant mesothelioma
  • On immunocytochemistry the tumour was positive for HBME-1, MNF 116, LP34, cam 5.2, CA19.9 and EMA, and negative for S100, CA125, AUA-1, CEA, CD15 and oestrogen receptors. The authors described this pattern as typical of malignant mesothelioma rather than reactive mesothelium or carcinoma
  • In the fluid samples, the cells were generally large and rounded, with abundant dense cytoplasm, a feathery cell border and prominent nucleoli, mixed with inflammatory cells. The cytoplasm was dense, compared with the translucent cytoplasm of benign cells
  • Small numbers of malignant cells were found on the surface of the ovaries and Fallopian tubes
  • The patient had survived for over a year and remained well at the time of the report
• The authors' conclusion: The authors concluded that peritoneal mesothelioma must be considered in non-asbestos-exposed females of a wide age range when interpreting ascitic fluid cytology. They also concluded that the unusual 'deciduoid' appearance of the cells and the wide age range of presentation present a diagnostic challenge
• Limitations the authors state:
  • The authors stated that the number of recorded cases is too small to establish a prognosis
  • The authors stated that further reports are needed to assess the diagnostic usefulness of the background inflammatory infiltrate seen in the fluid

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: Peritoneal Mesothelioma, Malignant Mesothelioma, Peritoneum, Laparotomy, Ascites, Omentum, Ascitic Fluid Cytology, Frozen Section.

Related studies

• Primary malignant deciduoid peritoneal mesothelioma: a report of the cytohistological and immunohistochemical appearances — H. Ustun, H.M. Astarci, et al. (2011)
• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)
• Primary malignant peritoneal mesothelioma: appearance on F-18 FDG positron emission tomographic images — T.N. Eade, M.J. Fulham, et al. (2002)
• Cystic appearance of a malignant peritoneal mesothelioma by ultrasonography and computed tomography: a case report — K.W. Preidler, H. Steiner, et al. (1994)
• Deciduoid peritoneal mesothelioma: CT findings with pathologic correlation — D.J. Chung, Y.W. Kang, et al. (2003)
• Peritoneal Deciduoid Malignant Mesothelioma on 67Ga SPECT/CT — Y.C. Lai, Y.C. Wu, et al. (2019)

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