Mucin‐positive epithelial mesothelioma of the peritoneum: Small bowel involvement
Mucin‐positive epithelial mesothelioma of the peritoneum: Small bowel involvement
复制标题
腹膜粘蛋白阳性上皮间皮瘤：小肠受累
DOI：
10.1111/j.1440-1827.2011.02732.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Y. Choi
中科院分区：
文献类型：
--
作者：
Jo‐Heon Kim;K. Kwon;Y. Jeon;J. Nam;Chan Choi;Chang‐Lim Hyeon;Y. Choi
粘蛋白阳性的上皮性间皮瘤仅在腹膜中报道过一次，且主要累及胃壁。我们报告第二个腹膜病例，这是第一个主要累及肠壁的病例。患者男，65岁，表现为十二指肠至回肠的弥漫性受累，左侧肾上腺有转移肿块。进行了小肠节段性切除；2个 月后患者死亡。光镜下可见弥漫的间变性上皮样细胞增殖和腺体形成灶，胞浆内或腺腔内可见颗粒状粘液物质。在组织化学上，这些粘蛋白材料是PAS阳性和淀粉酶抗性的。免疫组织化学显示，各种间皮细胞标志物均为阳性，少数腺癌标志物呈灶性阳性。在超微结构上，肿瘤细胞在顶端表面显示细长的微绒毛，与间皮瘤一致。在组织化学和免疫组织化学结果不明确的情况下，电子显微镜可以起决定性作用。
Mucin‐positive epithelial mesothelioma has been reported in the peritoneum only once, and that mainly involved the stomach wall. We report the second peritoneal case and this is the first case mainly involving the small bowel wall. A 65‐year‐old man showed diffuse involvement from the duodenum to the ileum and metastatic masses in the left adrenal gland. Segmental resection of the small bowel was performed; 2 months later the patient died. Light microscopy showed diffusely anaplastic epithelioid cell proliferation and foci of glandular formation with granular mucinous materials in the cytoplasmic vacuoles or within glandular lumina. Histochemically, these mucin materials were PAS‐positive and diastase‐resistant. Immunohistochemically, the various mesothelial markers were positive, and a few adenocarcinoma markers were focally positive. Ultrastructurally, the tumor cells showed long slender microvilli on the apical surface, consistent with mesothelioma. Electron microscopy can play a decisive role in the case of ambiguous histochemical and immunohistochemical results.