Malignant peritoneal mesothelioma, clear cell variant, in a female and its differentiation from clear cell carcinoma

Our plain-English summary of Malignant peritoneal mesothelioma, clear cell variant, in a female and its differentiation from clear cell carcinoma, by H. Hayashi, T. Kawata, I. Shimokawa (Pathology, Research and Practice, 2017).

The study

• Authors: H. Hayashi, T. Kawata, I. Shimokawa
• Journal: Pathology, Research and Practice
• Published: 2017;213(5):580-584
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Epithelial type malignant mesothelioma with a clear cell morphology is rare, and no case arising in the peritoneum of a female patient has been reported. Here we report a case of clear cell mesothelioma that developed in the peritoneum of a 61-year-old female. The patient died from massive ascites and respiratory failure 11days after her hospital admission. The autopsy demonstrated marked thickening of the omentum and a yellowish-whitish tumor diffusely covering the abdominal organs. The predominantly solid tumor was characterized microscopically by the growth of atypical cells with an abundant clear cytoplasm. The immunohistochemical study suggested mesothelioma rather than carcinoma. Electron microscopy showed the long and slender villi of the tumor cells, confirming the diagnosis. Primary clear cell carcinoma of the peritoneum, like clear cell mesothelioma, is rare and was also a diagnostic consideration in this patient. The differentiation between these two tumors is discussed herein.

Copyright © 2017 Elsevier GmbH. All rights reserved.

In plain English

This article is a case report from Nagasaki University in Japan about a 61-year-old woman who was hospitalized with abdominal swelling and pain. Tests on cells from fluid in her abdomen led doctors to suspect malignant mesothelioma. She died on the 11th day of hospitalization, and an autopsy was performed. The tumor had spread throughout the abdominal cavity, enclosing the abdominal organs, including the reproductive organs. It had also reached both pleural cavities and spread to organs such as the lungs and liver. The tumor cells had clear cytoplasm. Staining results were mixed and only suggested mesothelioma. Electron microscopy showed long villi on the tumor cells, which confirmed the diagnosis of malignant peritoneal mesothelioma, clear cell variant, rather than clear cell carcinoma. Detailed interviews found no history of asbestos exposure. The authors stated this was the first reported case of this variant in the peritoneum of a woman. They concluded that pathologists should be aware of it as a possible diagnostic pitfall.

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 (teaching case) with autopsy
• Who was studied: one 61-year-old woman, transferred to the authors' hospital (Nagasaki University, Japan) after being hospitalized at a nearby clinic
• Exposure: no history of asbestos exposure, according to detailed interviews
• Main results:
  • In cells taken from the abdominal fluid (ascites), the tumor cells were weakly positive for WT1, focally positive for CK5/6 and negative for MOC-31, so malignant mesothelioma was suspected
  • The patient died on the 11th day of hospitalization
  • At autopsy, the tumor had spread throughout the abdominal cavity and enclosed all abdominal organs, including the female reproductive organs
  • The tumor cells had abundant clear cytoplasm and frank nuclear atypia
  • The staining (immunohistochemical) pattern was confusing: partly positive for Ber-EP4, very few cells positive for calretinin, membranes positive for D2-40, and weak WT1 positivity
  • Electron microscopy showed long villi on the tumor cells, which confirmed malignant mesothelioma
  • The tumor extended to both pleural cavities and had spread to multiple organs, including the lungs, liver, pancreas and both adrenal glands
  • The authors stated this was the first reported case of the clear cell subtype involving the peritoneum in a female
• The authors' conclusion: The authors concluded that the clear cell subtype of malignant epithelial mesothelioma in the female peritoneal cavity may be a diagnostic pitfall, and that pathologists should be aware of its features

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Carcinoma, Malignant Mesothelioma, Peritoneum, Mesothelioma, Ascites, Autopsy, Omentum.

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