Clinicopathological Characteristics of Well-differentiated Papillary Mesothelioma of The Peritoneum: A Single-institutional Experience of 12 Cases
Clinicopathological Characteristics of Well-differentiated Papillary Mesothelioma of The Peritoneum: A Single-institutional Experience of 12 Cases
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DOI：
10.21873/invivo.11521
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发表时间：
2019-03-01
期刊：
影响因子：
2.3
通讯作者：
Kim, Hyun-Soo
中科院分区：
文献类型：
--
作者：
Kim, Moonsik;Kim, Hyun-Soo
背景/目的：分化良好的乳头状间皮瘤（WESTERN）的组织学特征是具有纤维血管核心的乳头状结构，内衬温和的间皮瘤细胞。我们最近经历了一例Wyndrome合并多发性腹膜包涵体囊肿，这促使我们开始全面审查以前诊断的Wyndrome病例。材料和方法：通过对12例腹膜WESTERN的电子病历、病理学检查和免疫组化等资料进行分析，探讨其临床病理特征和免疫表型。结果：患者年龄23 ~ 75岁。没有患者患有子宫内膜异位症或既往石棉暴露史。10例肿瘤在手术过程中因其他原因偶然发现。大多数肿瘤表现为腹膜表面的单个小结节，但在3例病例中，Wyndrome表现为多发性病变。除一名患者外，所有患者均无症状。所有患者术后无复发。组织学上，所有病例均表现出典型的乳头状结构和纤维血管核心。乳头内的间皮细胞多为单排细胞，少数可见细胞增殖成多层。细胞核淡染，2例细胞核轻度肿胀，核仁明显。免疫组化显示间皮细胞D2-40、细胞角蛋白5/6、细胞角蛋白7和Wilms肿瘤1阳性。结论：我们在此展示了腹膜WDPMs的临床病理特征。疣体具有明显的病理特征。虽然我们检查的所有病例在手术后都平安无事，但由于Wyndrome的生物学行为仍然不确定，建议进一步监测。
Background/Aim: Well-differentiated papillary mesothelioma (WDPM) is histologically characterized by papillary architecture with fibrovascular cores, lined by bland mesothelial cells. We recently experienced a case of WDPM associated with multiple peritoneal inclusion cysts, which prompted us to initiate a comprehensive review of previously diagnosed WDPM cases. Materials and Methods: The clinicopathological characteristics and immunophenotype of 12 cases of peritoneal WDPM were investigated using a review of electronic medical records, pathological examination, and immunostaining. Results: The patients' ages ranged from 23 to 75 years. No patient had endometriosis or a previous history of asbestos exposure. Ten tumors were detected incidentally during surgery for other causes. Most tumors appeared as a small, single nodule on the peritoneal surface, but in three cases, WDPM presented as multiple lesions. All but one patient had no symptoms. All the patients examined are still well without postoperative recurrence. Histologically, all cases demonstrated typical papillary architecture with fibrovascular cores. The mesothelial cells lining the papillae consisted mostly of single row of cells, although areas of proliferation to multiple layers were observed in a few cases. Their nuclei appeared bland, but two cases exhibited mild nuclear atypia and prominent nucleoli. Immunostaining revealed that the mesothelial cells were positive for D2-40, cytokeratin 5/6, cytokeratin 7, and Wilms' tumor 1. Conclusion: We herein demonstrated the clinicopathological characteristics of peritoneal WDPMs. WDPM has distinct pathological features. Although all cases we examined were uneventful after surgery, further surveillance is recommended since the biological behavior of WDPM is still uncertain.