Primary malignant deciduoid peritoneal mesothelioma: a report of the cytohistological and immunohistochemical appearances

Our plain-English summary of Primary malignant deciduoid peritoneal mesothelioma: a report of the cytohistological and immunohistochemical appearances, by H. Ustun, H.M. Astarci, N. Sungu, et al (Diagnostic Cytopathology, 2011).

The study

• Authors: H. Ustun, H.M. Astarci, N. Sungu, A. Ozdemir, C. Ekinci
• Journal: Diagnostic Cytopathology
• Published: 2011;39(6):402-8
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant deciduoid mesothelioma (MDM) is a rare variant of epithelioid mesothelioma. This type of tumor might be associated with the asbestos exposure and carries a poor prognosis in general. MDM was first described by Nascimento et al. in 1994 in a peritoneal lesion of a young woman. And its diagnosis is frequently mistaken with florid mesothelial hyperplasia and peritoneal deciduosis. There are 44 MDM cases reported in the literature up today. A 59-year-old woman patient referred to our clinic was identified with an abdominal mass. Computed tomography of whole abdomen of the patient showed a mass with the widest transverse dimension of 65 × 60 mm at abdominal bifurcation in the mesenteric region. The patient was diagnosed with MDM after the cytopathological examination of the fine needle aspiration biopsy performed from the mass. Consequently, she received a total mass excision and right hemicolectomy under general anesthesia. The cytomorphological appearance of the ascitic fluid is detailed for the first time by Gillespie et al. and is described only in two manuscripts. In the present study, we aimed to report a case of a 59-year-old woman since she was diagnosed with MDM and because her cytological findings were further supported by histomorphological and immunohistochemical evaluations of the operation material obtained from the patient.

Copyright © 2010 Wiley-Liss, Inc.

In plain English

This case report described one 59-year-old woman admitted to a hospital in Ankara, Turkey, in October 2008 with shortness of breath and back pain. The article states she had no history of asbestos exposure. A CT scan showed a 65 by 60 mm mass in the mesenteric region of the abdomen. After examining cells taken by needle aspiration biopsy, the authors diagnosed malignant deciduoid mesothelioma (MDM), a rare form of epithelioid mesothelioma, here in the peritoneum. She then had the mass removed, together with a right hemicolectomy (removal of the right side of the colon). The removed tumor measured 8 by 8 by 5.5 cm, showed few cell divisions and no necrosis, and had not invaded the colon wall. Tissue stains reacted strongly and diffusely for vimentin and cytokeratin 5/6, focally for calretinin and HBME-1, and not at all for six other markers. The authors stated that these findings supported the cytological diagnosis. At the time of writing she was alive with no signs of disease. The authors concluded that pathologists must recognize this tumor's cell features for timely diagnosis.

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 cytological, histological and immunohistochemical examination
• Who was studied: One 59-year-old woman admitted to a hospital in Ankara, Turkey, on October 10, 2008, with shortness of breath and back pain
• Exposure: The article states the patient had no history of asbestos exposure; no fiber type or occupation is described
• Main results:
  • CT of the whole abdomen showed a mass measuring 65 by 60 mm at its widest, at the abdominal bifurcation in the mesenteric region
  • Based on the cytological (cell) findings from the aspiration biopsy, the authors diagnosed malignant deciduoid mesothelioma
  • The surgically removed tumor measured 8 by 8 by 5.5 cm
  • The tumor showed few normal cell divisions (mitoses), no necrosis, and did not invade the colon wall
  • Tumor sections showed strong, diffuse staining for vimentin and cytokeratin 5/6
  • Tumor sections showed focal staining for calretinin and HBME-1
  • Tumor sections were negative for CEA, cytokeratin 7, cytokeratin 20, CD117, CD34 and alpha-smooth muscle actin
  • The histological and immunohistochemical findings were consistent with the cytological findings and supported the MDM diagnosis
  • After total mass excision and right hemicolectomy, the patient was alive with no signs of the disease at the time of the report
• The authors' conclusion: The authors concluded that cytopathologists and surgical pathologists must accurately interpret the cell findings of MDM and not miss its characteristic large, round, polygonal cells, so that the diagnosis is timely and precise

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, Mesothelioma, Epithelioid, Asbestos Exposure, Prognosis, Reactive Mesothelial Hyperplasia, Biopsy.

Related studies

• Malignant biphasic peritoneal mesothelioma in a child: fine-needle aspiration cytology, histopathology, and immunohistochemical features along with review of literature — S.K. Arora, R. Srinivasan, et al. (2012)
• Expression of thrombomodulin, calretinin, cytokeratin 5/6, D2-40 and WT-1 in a series of primary carcinomas of the lung: an immunohistochemical study in comparison with epithelioid pleural mesothelioma — C.E. Comin, L. Novelli, et al. (2014)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Deciduoid peritoneal mesothelioma. A report of the cytological appearances — F.R. Gillespie, J.D. van der Walt, et al. (2001)
• Primary malignant peritoneal mesothelioma: appearance on F-18 FDG positron emission tomographic images — T.N. Eade, M.J. Fulham, et al. (2002)
• Expression of calretinin, thrombomodulin, keratin 5, and mesothelin in lung carcinomas of different types: an immunohistochemical analysis of 596 tumors in comparison with epithelioid mesotheliomas of the pleura — M. Miettinen, M. Sarlomo-Rikala (2003)

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