Morphological studies of mesothelial cells in CAPD effluent and their clinical significance

Mesothelial metaplasia in European pond turtle, Emys orbicularis (Testudines: Emydidae) infected with Spiroxys contortus (Nematoda: Spirurida)

“…Pathogenic significance of hypertrophic mesothelial cells has been assessed in peritoneal effluent in humans but also in ex vivo human peritoneal cell cultures (Bajo et al, 2004). Although the presence of hypertrophic mesothelial cells in peritoneal effluent has been considered a marker for peritoneal sclerosis (Yamamoto et al, 1998), other authors have found no remarkable functional abnormalities suggestive of severe peritoneal damage (Izumotani et al, 2001). However, Bajo et al (2004) conclude that the presence of hypertrophic mesothelial cells is not necessarily a marker of sclerosing peritonitis and that such cells may be observed in cultures from new peritoneal effluent patients with no peritoneal function abnormalities.…”

Correlation between Peritoneal Mesothelial Cell Cytology and Peritoneal Histopathology with Respect to Prognosis in Patients on Continuous Ambulatory Peritoneal Dialysis

“…Fifty milliliters of dialysate effluent collected after an 8- to 10-hour overnight hospitalization with 1.5 or 2.5% dextrose dialysate solution was centrifuged (1,500 rpm, 4°C, 10 min), and a 500-µl cell suspension was made into a cytospin preparation (800 rpm, 25°C, 5 min). The smear preparation was stained with May-Grünwald Giemsa for light microscopy [1]. The microscopic image was converted into a digital image (Photograb II, Fuji, Tokyo, Japan) and automatically processed using software (MacSCOPE, Mitani, Tokyo, Japan) to measure parameters (surface areas of cell, nucleus, and cytoplasm) from which nucleocytoplasmic ratios (N/C ratio) were calculated.…”

“…Continuous ambulatory peritoneal dialysis (CAPD) is a commonly used modality in the treatment of end-stage renal disease; however, several degenerative changes in the peritoneum occurring after a prolonged duration of CAPD have been reported [1, 2, 3, 4]. These changes include peritoneal fibrosis, peritoneal sclerosis, and sclerosing peritonitis, with increasing pathologic severity [3, 5, 6].…”

“…Peritoneal sclerosis and sclerosing peritonitis have frequently been reported to progress to sclerosing encapsulating peritonitis (SEP) [5, 7]. SEP presents clinically with ileus-like symptoms that appear continuously, intermittently, or recurrently as a result of adhesion formation in a diffusely thickened peritoneum [1]. Although pathologic examination of the peritoneum in SEP may show a variety of degenerative changes, such as peritoneal fibrosis, peritoneal sclerosis, or sclerosing peritonitis, SEP generally has a poor clinical prognosis [6, 7, 8].…”

“…Mesothelial cells in the effluent have been examined to assess peritoneal function and biocompatibility of the dialysate [10], but a correlation with peritoneal pathology or clinical prognosis has not been extensively studied. In a previous study, we assessed the morphologic changes in mesothelial cells in the effluent [1]: mesothelial cells were classified into three types (normal cells, dyskaryotic cells, and giant cells) based on morphologic appearance. There was a highly significant, positive correlation between the duration of CAPD and the mean surface area of mesothelial cells.…”