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

Abstract

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.

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

“…15 According to published reports, deciduoid mesotheliomas are composed of large, polygonal, round, or ovoid cells having well-defined cell borders, abundant eosinophilic, glassy cytoplasm, and round vesicular nuclei presenting prominent nucleoli. 8,24 Additionally, nuclear pleomorphism, nuclear pseudoinclusions, 8,18,24 and binucleated or multinucleated cells have also been mentioned as being present in some of the reported cases. 8,9,23,24 Mitotic activity has been documented as being variable and, although some reports have mentioned that the tumor had high mitotic activity and the presence of atypical mitoses, [2][3][4][5]8 others have indicated that only rare or few mitoses were present.…”

“…8,24 Additionally, nuclear pleomorphism, nuclear pseudoinclusions, 8,18,24 and binucleated or multinucleated cells have also been mentioned as being present in some of the reported cases. 8,9,23,24 Mitotic activity has been documented as being variable and, although some reports have mentioned that the tumor had high mitotic activity and the presence of atypical mitoses, [2][3][4][5]8 others have indicated that only rare or few mitoses were present. 11,13,14,21,24 In addition to the previously mentioned morphological features, some of the published reports have included other findings that, although uncommon, can also occur in deciduoid mesotheliomas.…”

“…8,9,23,24 Mitotic activity has been documented as being variable and, although some reports have mentioned that the tumor had high mitotic activity and the presence of atypical mitoses, [2][3][4][5]8 others have indicated that only rare or few mitoses were present. 11,13,14,21,24 In addition to the previously mentioned morphological features, some of the published reports have included other findings that, although uncommon, can also occur in deciduoid mesotheliomas. These include the presence of focal areas in which the cells present foamy, 18 vacuolated 10,11 or clear cytoplasm, 15,19 prominent intracytoplasmic lumina, 3,5,15 focal rhabdoid changes, 7,19 and mucinous or myxoid stroma.…”

“…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 …”

Decidualização Ectópica: Uma Entidade Esquecida

“…58 Na deciduose ovárica, a ecografia pélvica mostra espessamento do estroma com neovascularização, de natureza papilar, mimetizando os achados ultrassonográficos sugestivos de malignidade. 40 Nestes casos, na ressonância magnética a lesão ovárica de deciduose apresenta caracteristicamente isointensidade com a placenta, auxiliando a diferenciação Tabela 3 -Painel dos principais anticorpos usados na técnica de imunohistoquímica para diagnóstico diferencial 20,22,33,34,38,50,59,61,75 entre decidualização e malignidade.…”