Malignant mesothelioma of peritoneum

Our plain-English summary of Malignant mesothelioma of peritoneum, by N. Weidner (Ultrastructural Pathology, 1991).

The study

• Author: N. Weidner
• Journal: Ultrastructural Pathology
• Published: 1991;15(4-5):515-20
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 57-year-old man with malaise, ascites, and abdominal pain was found to have a peritoneum studied with numerous, small nodular tumor masses. Light microscopy revealed an anaplastic malignant tumor of uncertain differentiation. Mucin stains were negative. Electron microscopy revealed pleomorphic tumor cells with diffusely distributed cytoplasmic tonofilaments and well-developed true desmosomes. No long, thin, branching microvilli were present, yet tumor cells were strongly positive for both callus keratin (polyclonal) and monoclonal cytokeratin (AE1/3) in a diffuse cytoplasmic distribution (a pattern corresponding to the diffuse cytoplasmic tonofilaments). Tumor cells were negative for Leu-M1 and carcinoembryonic antigen. The findings were most consistent with malignant mesothelioma, and additional questioning, after tissue diagnosis, revealed a work history of asbestos exposure.

In plain English

This was a case report from the Department of Pathology at Brigham and Women's Hospital, Boston. It described a 57-year-old man who had malaise, abdominal pain, fever, fluid in the abdomen (ascites) and weight loss. At surgery, many irregular nodular tumor masses covered much of the abdominal lining (peritoneum) and the omentum, and a cancer starting in the pancreas could not be totally excluded. Under the light microscope the tumor was poorly differentiated, with no glands, and stains for mucin were negative. Electron microscopy showed true desmosomes and tonofilaments spread through the cytoplasm, but no long, thin microvilli. The tumor cells stained strongly for two keratin markers (callus keratin and AE1/3) and were negative for CEA and Leu-M1. The author concluded that these features were most consistent with malignant mesothelioma of the peritoneum. The patient had been uncertain about any asbestos exposure. After the diagnosis, a history of work-related exposure was obtained: he had worked with asbestos filters 25 years earlier. The discussion reviewed features that distinguish poorly differentiated mesothelioma from carcinoma.

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 a review of diagnostic electron microscopic and immunohistochemical features
• Who was studied: one 57-year-old man with malaise, abdominal pain, fever, ascites and weight loss; the author was at Brigham and Women's Hospital, Boston; the date of the case is not stated
• Exposure: work-related asbestos exposure from working with asbestos filters 25 years earlier; no fiber type stated
• Main results:
  • At surgery, the tumor diffusely involved much of the peritoneal surface and the omentum
  • Light microscopy showed no glands or other identifiable differentiation, and mucin stains were negative
  • Electron microscopy showed well-developed true desmosomes and diffusely distributed tonofilaments, with no well-formed long, thin microvilli
  • Tumor cells were strongly positive for polyclonal callus keratin and monoclonal cytokeratin (AE1/3)
  • Tumor cells were negative for CEA and Leu-M1
  • The patient was initially uncertain about asbestos exposure, but a work-related exposure history was obtained after the final diagnosis
• The authors' conclusion: The author concluded that the tumor's ultrastructural and immunohistochemical features were most consistent with malignant mesothelioma

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: Malignant Mesothelioma, Peritoneum, Ascites, Pleomorphic, Monoclonal, Carcinoembryonic Antigen (CEA), Work History, Asbestos Exposure.

Related studies

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• Cystic mesothelioma of the peritoneum. A report of three cases — S. Villaschi, F. Autelitano, et al. (1990)
• Malignant epithelial mesothelioma of the peritoneum: observations on a problem case — B.P. Eyden, S. Banik, et al. (1996)
• Concomitant malignant mesothelioma of the pleura, peritoneum, and tunica vaginalis testis — V. Ascoli, F. Facciolo, et al. (1996)
• Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases — U. Raju, G. Fine, et al. (1989)
• Benign papillary mesothelioma of peritoneum: a histological, histochemical and ultrastructural study of six cases — J.R. Goepel (1981)

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