Localised pleural malignant mesothelioma. Report of two cases simulating pulmonary carcinoma and review of the literature

Asioli, Sofia; Piaz, Giulia Dal; Damiani, Stefania

doi:10.1007/s00428-004-1062-9

Cited by 19 publications

(8 citation statements)

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“…9,12,18 These findings are comparable to those of the present investigation in that those tumors with a high number of mitoses (45 per 10 HPF), a decrease in cell cohesion, highly atypical nuclei that vary in their size and often contain cytoplasmic inclusions, and large, sometimes multiple nucleoli tend to behave in a more aggressive manner than those in which the mitotic activity was low, the cells were more uniform and more cohesive, and the nuclei exhibited less atypia. In the present series, 7 of the cases (Cases 1, 2, 6, 7, 8, 13, and 15) that were considered to belong to the first group died of disease 4-17 months (mean, 7 months) after diagnosis, while 9 of the 10 cases ( Cases 5,12,14,16,17,18,19,20, and 21) that were considered to belong to the second group died of disease 6-62 months (mean, 22 months) after diagnosis and the remaining patient (Case 4) was alive 25 months following diagnosis (Table 3). These observations appear to be in agreement with a recent investigation that indicated that nuclear grading based on nuclear features and mitotic count can provide prognostic information in epithelioid diffuse malignant pleural mesothelioma.…”

Section: Discussionmentioning

confidence: 65%

“…5 In these reports, however, it was demonstrated that mesotheliomas with deciduoid features can also originate in the pleura, occur in elderly men, and be associated with asbestos exposure. Since then, several other cases, mostly individual case reports, have been published [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] (Table 1). Although patient survival in many of the published cases has been short and limited to a few months after diagnosis, thus suggesting that deciduoid mesotheliomas have an aggressive clinical course, patients with long survival …”

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Deciduoid mesothelioma: report of 21 cases with review of the literature

Ordóñez

2012

Modern Pathology

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Deciduoid mesothelioma is a rare variant of epithelioid mesothelioma that was initially considered to occur exclusively in the peritoneum of young women who had no history of asbestos exposure and to be characterized by an aggressive clinical course, but it was later demonstrated that this tumor could also occur in the pleura of older men and women who had been exposed to asbestos. Some subsequent studies have also indicated that the clinical course is no different from that of conventional epithelioid mesothelioma. Herein are reported 21 cases of deciduoid mesothelioma that were investigated using a large panel of immunohistochemical markers, 9 of which were also studied by electron microscopy. Fifteen of the patients were male and 6 were female (mean age, 60 years). Seventeen of the cases originated in the pleura and four in the peritoneum. Histologically, all of the cases were composed of large, polygonal or ovoid cells with well-defined cell borders, dense eosinophilic cytoplasm, and single or multiple nuclei. In some cases, the cells exhibited a wide variation in their size and shape, frequent loss of cell cohesion, marked nuclear atypia, and high mitotic activity (45 per 10 HPF); whereas, in others, the cells were more cohesive, less pleomorphic, and the mitotic activity low. As the survival of patients in the first group of cases was shorter (mean, 7 months), when compared with that of the latter (mean, 23 months), it is concluded that the differences in prognosis reported in deciduoid mesothelioma are due to the existence of a high-grade subgroup that presents highly aggressive clinical behavior. Therefore, when a high-grade deciduoid mesothelioma is present, it should be reported as it can significantly affect prognosis and treatment. The use of immunohistochemistry and electron microscopy in assisting in the differential diagnosis of deciduoid mesothelioma is also discussed.

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Section: Discussionmentioning

confidence: 65%

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confidence: 99%

Deciduoid mesothelioma: report of 21 cases with review of the literature

Ordóñez

2012

Modern Pathology

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“…1,2 Typical clinical presentations include bloody body cavity effusion and macroscopic findings of tumor nodules or diffuse thickening of the serosal surface ( Figure 1). Rarely, MM presents with a localized mass 3 (see below). Unilateral, recurrent, hemorrhagic pleural effusion is the predominant clinical finding in most patients with diffuse pleural MM.…”

Section: Epithelioid Malignant Mesotheliomamentioning

confidence: 99%

“…Most reported cases of localized MM have developed in the pleura or as intrapulmonary or mediastinal tumors, but peritoneal localization and even hepatic and pancreatic tumors with visceral peritoneal origin have also been reported. 3,[74][75][76][77] All histologic subtypes and different morphologic patterns of MM have been described in association with localized MM. Localized MM has a better prognosis than diffuse MM because it is often surgically treatable.…”

Section: Localized MMmentioning

confidence: 99%

Epithelioid Lesions of the Serosa

Anttila

2012

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Diagnosing epithelioid serosal lesions remains a challenge because numerous different processes—primary or secondary, benign or malignant—occur in body cavities, some of which are very rare. Objectives.—To review the newest literature and to describe the morphologic criteria and immunohistochemical markers that are useful for distinguishing epithelioid serosal lesions. Data Sources.—Previously published literature concentrating on the newest research findings. Earlier reviews are principally referred to for established diagnostic criteria. Conclusions.—Immunohistochemistry with a panel of antibodies has made the diagnosis of epithelioid serosal lesions very reliable. When deciding on antibodies used in differential diagnosis, it is important to consider tumor location, clinical and radiologic information, and morphologic features. Immunohistochemistry is less useful in the differential diagnosis of benign versus malignant mesothelial lesions. The diagnosis of benign versus malignant mesothelial proliferations still relies on the histologic criteria of invasion.

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“…Until now, 44 MDM cases have been documented in the literature (Table I). 1–24 The deciduoid features of malignant mesothelioma was first characterized by Talerman et al in a 13‐year‐old girl where the authors reported primary peritoneal malignant mesothelioma consisting of conspicuous large cell clusters containing deciduoid‐like cells 1. Later in 1994, Nascimento et al described a mass with similar morphological features in a peritoneal lesion of a young woman and named it as MDM as a new entity 2…”

Section: Cases Of Deciduoid Mesotheliomamentioning

confidence: 99%

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

M.D.

Astarci

Süngü

et al. 2011

Diagnostic Cytopathology

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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.

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Localised pleural malignant mesothelioma. Report of two cases simulating pulmonary carcinoma and review of the literature

Abstract: Localised malignant mesotheliomas are unusual and predominantly intrapulmonary growth is rare. Pathologists should be aware of this possibility to avoid misdiagnosis, particularly in small biopsies.

Cited by 19 publications

References 7 publications

Deciduoid mesothelioma: report of 21 cases with review of the literature

Deciduoid mesothelioma: report of 21 cases with review of the literature

Epithelioid Lesions of the Serosa

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

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