Malignant peritoneal mesothelioma with squamous metaplasia

Our plain-English summary of Malignant peritoneal mesothelioma with squamous metaplasia, by T. Matsuo, H. Ito, M. Anami, et al (Cytopathology, 1993).

The study

• Authors: T. Matsuo, H. Ito, M. Anami, T. Ikeda, S. Nishihata
• Journal: Cytopathology
• Published: 1993;4(6):373-8
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors described a case of malignant peritoneal mesothelioma that partly showed the histological features of squamous carcinoma, in a man with past asbestos exposure, from Nagasaki, Japan. The 48-year-old man had worked continuously with asbestos, lagging pipes, from age 17 to 30. He was admitted with a 6-month history of lower abdominal distention. Computed tomography showed ascites and a mass of the omentum, and cytology of the fluid showed malignant cells compatible with mesothelioma. At laparotomy, about 1000 ml of bloody fluid was found, along with massive omental tumour and thickening of the entire peritoneum. As much tumour as possible was removed. Histology confirmed peritoneal mesothelioma. After chemotherapy with cisplatin, doxorubicin and cyclophosphamide, he stayed free of ascites for 6 months. He then developed paralytic ileus, renal failure and metastatic tumour, and died 7 months later. The ascitic fluid contained atypical mesothelial cells and a few cells resembling keratinizing squamous carcinoma. At autopsy, the tumour was mixed epithelial and sarcomatous mesothelioma. One nodule contained squamous cells with intercellular bridging and keratinization that merged with mesothelioma. Both lungs and the hilar lymph nodes showed asbestosis. The squamous areas stained for high molecular weight cytokeratins. The authors could not entirely exclude two separate tumours, but found no independent primary squamous carcinoma. They suggested that multipotential subserosal cells can undergo squamous metaplasia.

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 article was a case report about one patient in Japan. A 48-year-old man was admitted to hospital after six months of lower abdominal swelling. He had worked continuously with asbestos, lagging pipes, from age 17 to 30. The article did not name the fiber type. Fluid from his abdomen contained malignant cells compatible with mesothelioma, and surgery confirmed malignant mesothelioma of the peritoneum, the lining of the abdomen. After surgery and chemotherapy he stayed well for 6 months. He then developed paralytic ileus (a stalled bowel), kidney failure and spreading tumour, and died 7 months later. At autopsy the tumour encased the liver, spleen and pancreas and had invaded the left diaphragm and pleura. Under the microscope it mixed epithelial and sarcomatous patterns. One nodule contained squamous cancer cells that merged with the mesothelioma. Asbestosis was found in both lungs. The authors could not entirely exclude two separate tumours, but autopsy found no separate squamous cancer. They concluded that the tumour's staining pattern suggested certain cells beneath the lining can undergo squamous metaplasia.

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
• Who was studied: one 48-year-old man treated in Nagasaki, Japan, who had a 6-month history of lower abdominal swelling
• Exposure: continuous occupational asbestos work lagging pipes from age 17 to 30; no fiber type is given
• Main results:
  • Fluid cytology showed malignant cells compatible with mesothelioma, and tissue examination confirmed malignant mesothelioma of the peritoneum
  • After surgery and chemotherapy (cisplatin, doxorubicin and cyclophosphamide) the patient was well and free of ascites for 6 months, then developed paralytic ileus, renal failure and metastatic tumour, and died 7 months later
  • At autopsy the tumour encased the liver, spleen and pancreas and had invaded the left diaphragm and pleura; no primary tumour was found in the abdominal organs
  • The tumour mixed epithelial and sarcomatous components
  • A whitish nodule contained abnormal squamous cells with keratinization that merged with mesothelioma
  • Asbestosis was found in both lungs and in the hilar lymph nodes
  • Staining was negative for CEA, desmin and CA125 throughout the tumour
• The authors' conclusion: The authors concluded that the tumour's pattern of immunoreactivity suggests that 'multipotential subserosal cells' can undergo squamous metaplasia
• Limitations the authors state:
  • The authors could not entirely exclude that two separate tumours were present, although no independent primary squamous cell carcinoma was found at autopsy

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, Carcinoma, Asbestos Exposure, Ascites, Omentum, Cytology, Mesothelioma, Laparotomy.

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