Well-differentiated papillary mesothelioma: a clinicopathological and immunohistochemical study of 18 cases with additional observation

Our plain-English summary of Well-differentiated papillary mesothelioma: a clinicopathological and immunohistochemical study of 18 cases with additional observation, by X. Chen, W. Sheng, J. Wang (Histopathology, 2013).

The study

• Authors: X. Chen, W. Sheng, J. Wang
• Journal: Histopathology
• Published: 2013;62(5):805-13
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aims: To present our experience with 18 cases of well-differentiated papillary mesothelioma (WDPM), with an emphasis on its relationship to adenomatoid tumour and multicystic mesothelioma.

Methods And Results: Eighteen cases of WDPM were retrieved. Twenty cases of multicystic mesothelioma were selected for comparative study. The WDPM patients comprised 14 females and four males, with age ranging from 18 to 60 years (median 37 years). The tumour involved the abdominal or pelvic peritoneum (14 cases), the pleura (two cases), and the testicular tunica vaginalis (two cases). The majority of WDPMs were incidental findings during surgery for a wide variety of conditions. Histologically, 13 cases were consistent with classical WDPM. Two cases had a combined component of adenomatoid tumour, and three cases contained coexisting areas of multicystic mesothelioma. Among the multicystic mesothelioma cases, four had adenomatoid tumour-like foci present in the stroma. Immunohistochemically, all cases of WDPM and multicystic mesothelioma, as well as the coexisting combined components, were positive for mesothelial markers, with a low Ki67 index. This study also showed that WDPM was negative for epithelial membrane antigen and desmin.

Conclusions: The simultaneous occurrence of WDPM, adenomatoid tumour and multicystic mesothelioma in some cases suggested histogenetic relationships among these three less aggressive mesotheliomas.

© 2012 Blackwell Publishing Ltd.

In plain English

This was a pathology case series from Fudan University Cancer Hospital in Shanghai, China. The authors reviewed 18 cases of well-differentiated papillary mesothelioma (WDPM) and, for comparison, 20 cases of multicystic mesothelioma, collected from consultation and surgical pathology files from 2000 to 2011. The WDPM patients were 14 women and four men aged 18 to 60 (median 37). The tumour involved the abdominal or pelvic peritoneum in 14 cases, the pleura in two and the testicular tunica vaginalis in two. Most peritoneal tumours were found incidentally during surgery. Apart from one patient with lung carcinoma and pleural WDPM, none had a history of occupational asbestos exposure. Thirteen cases were classical WDPM. Two also contained adenomatoid tumour and three contained multicystic mesothelioma. Four of the 20 multicystic mesotheliomas had adenomatoid tumour-like areas. All cases stained strongly for mesothelial markers, with a Ki67 index below 1%. All WDPM cases were negative for EMA and desmin. Of 16 patients followed, eight had no evidence of disease and seven had no tumour progression. One died of carcinoma of the uterine cervix at 74 months. The authors concluded that the findings suggest a histogenetic relationship among the three tumour types.

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: Clinicopathological and immunohistochemical case series (retrospective review of pathology cases), with a comparison group of multicystic mesothelioma cases
• Who was studied: 18 patients with WDPM (14 females, 4 males, aged 18 to 60, median 37) and 20 comparison cases of multicystic mesothelioma, from the consultation and surgical pathology files of the authors' department in Shanghai, China, dating from 2000 to 2011
• Exposure: Not an exposure study, and no fiber types or doses were given. The authors report that, apart from one patient with concurrent lung carcinoma and pleural WDPM, none of the patients had a history of occupational asbestos exposure.
• Main results:
  • WDPM patients were 4 males and 14 females, aged 18 to 60 years (median 37 years)
  • Tumour sites among the 18 WDPM cases: abdominal or pelvic peritoneum 14, pleura 2, testicular tunica vaginalis 2
  • Most peritoneal WDPMs were incidental findings during surgery done for other conditions
  • 13 of the 18 WDPM cases showed the typical features of classical WDPM
  • Two WDPM cases (cases 14 and 16) had a combined component of adenomatoid tumour
  • Three other WDPM cases contained cystic areas consistent with multicystic mesothelioma
  • In 4 of the 20 multicystic mesothelioma cases, adenomatoid tumour-like foci were found in the stroma
  • All WDPM and multicystic mesothelioma cases expressed the mesothelial markers calretinin, cytokeratin 5/6, D2-40 and WT1, and the Ki67 index was below 1%
  • All WDPM cases were negative for EMA and desmin
  • In the five composite WDPMs, the coexisting adenomatoid tumour and multicystic mesothelioma components had the same immunophenotypes as the WDPM
  • Follow-up was available for 16 patients, lasting 5 to 136 months (median 59.5 months). Eight were alive with no evidence of disease.
  • Among the 16 followed patients, seven had an uneventful course with no signs of tumour progression
  • Among the 16 followed patients, one died of carcinoma of the uterine cervix at 74 months
• The authors' conclusion: The authors concluded that the close association of WDPM with adenomatoid tumour and multicystic mesothelioma, and of multicystic mesothelioma with adenomatoid tumour, suggests a histogenetic relationship among these three entities

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: Well-Differentiated Papillary Mesothelioma, Adenomatoid Tumor, Multicystic Mesothelioma (MCM), Peritoneum, Pleura, Tunica Vaginalis, Epithelial Membrane Antigen (EMA), Desmin.

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• Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: Case Report and Systematic Review of Literature — W.K. Tan, M.Y. Tan, et al. (2016)
• Clinicopathological Characteristics of Well-differentiated Papillary Mesothelioma of The Peritoneum: A Single-institutional Experience of 12 Cases — M. Kim, H.S. Kim (2019)
• Well differentiated (benign) papillary mesothelioma of the tunica vaginalis — R. Chetty (1992)
• Well-differentiated papillary mesothelioma: A 17-year single institution experience with a series of 75 cases — M. Sun, L. Zhao, et al. (2019)

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