Immunohistochemical evidence of the mesothelial histogenesis of a uterine adenomatoid tumor

Our plain-English summary of Immunohistochemical evidence of the mesothelial histogenesis of a uterine adenomatoid tumor, by Y. Satoh, M. Hiraguchi, T. Matuura, et al (The Journal of Obstetrics and Gynaecology Research, 1998).

The study

• Authors: Y. Satoh, M. Hiraguchi, T. Matuura, K. Takasu
• Journal: The Journal of Obstetrics and Gynaecology Research
• Published: 1998;24(2):91-101
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We present rare case of a uterine adenomatoid tumor. In order to characterize the diversity of immunoreactive antigens associated with mesothelial differentiation, we immunohistochemically examined the tumor's epithelioid and myofibromatoid components, as well as the biphasic pattern of its adenomatoid changes. Immunostaining of tumor cells was positive for high- and low-molecular-weight cytokeratins and vimentin. Specific immunoreactions with antibodies against desmin, alpha-actin, and the S-100 protein also were observed. The present adenomatoid tumor can be explained in terms of various transformations and typical alterations in mesothelioma cells: (1) the mesothelial cells had differentiated to epithelial and stromal components, concomitant with the presence of predominant reactive foci; (2) intermediate cells expressed different types of cytoskeletal intermediate filament proteins (IMPs); and (3) the patterns of fibromatoid and leiomyoid differentiation resembled those of a benign mesothelioma of the ovarian or oviductal peritoneum. Our immunohistochemical investigations indicated that the present tumor exhibited the histogenesis of a true mesothelioma, an adenomatoid mesothelioma.

In plain English

This case report described one 42-year-old woman admitted to the authors' hospital; the authors worked in Kyoto, Japan. She had her uterus and one ovary removed to treat recurrent endometriosis. The article does not mention asbestos. The authors found a single 2.5 cm by 3.0 cm nodule in the uterus that appeared well-circumscribed and unencapsulated. They studied it as an adenomatoid tumor, a tumor of the cells lining body cavities (mesothelial cells). Electron microscopy showed some cells partway between lining cells and spindle-shaped connective-tissue cells. Staining was positive for keratin, vimentin, desmin, alpha-actin and S-100 protein. It was negative for several other markers, including the blood-vessel markers factor VIII-related antigen and UEA-1. The authors concluded that the tumor was mesothelial in origin and unlike an ordinary uterine adenomatoid tumor. The authors called it benign, but its classification varies: the abstract says it showed the histogenesis of a true mesothelioma, while the introduction contrasts it with a true peritoneal mesothelioma. The authors noted that vimentin staining could not separate tumor from reactive cells, and that several antibodies used can give false-positive or conflicting results.

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), with light microscopy, electron microscopy and immunohistochemical staining of the tumor
• Who was studied: one 42-year-old woman (gravida 3, para 2) admitted to the authors' hospital for simple hysterectomy and unilateral oophorectomy for recurrent external endometriosis. The hospital is not named; the authors' affiliations are in Kyoto, Japan. The article was received in 1997.
• Main results:
  • A single nodule measuring 2.5 cm by 3.0 cm was found in the right horn of the patient's uterus. It appeared well-circumscribed and unencapsulated.
  • The authors described the lesion in the patient as a localized benign mesothelioma
  • The patient's tumor stained positive for keratin, vimentin, desmin, alpha-actin and S-100 protein
  • In the patient's tumor, low-molecular-weight cytokeratin was expressed distinctly and high-molecular-weight cytokeratin focally
  • Antibodies against EMA, Ber-EP4, factor VIII-related antigen, CA125, CEA, amylase, HMFG-2 and Leu-M1, and the lectin UEA-1, did not react with the tumor cells
  • Under electron microscopy, the authors saw clusters of intermediate cells that appeared to be in transition between spindle-shaped mesenchymal cells and polygonal epithelial cells
• The authors' conclusion: The authors concluded that the tumor showed the histogenesis of a true mesothelioma, an adenomatoid mesothelioma. They also wrote that it was not the same as an ordinary uterine adenomatoid tumor, and that the negative marker results indicated a benign mesothelial tumor.
• Limitations the authors state:
  • Vimentin expression did not allow the authors to distinguish between neoplastic and reactive mesothelial states
  • The authors noted that results for several antibodies (EMA, Ber-EP4, Leu-M1, HMFG-2) are debatable because these antibodies often give false-positive or conflicting results

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, Epithelioid, Biphasic Mesothelioma, Desmin, S-100, Mesothelioma, Mesothelial Cells, Peritoneum.

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