Isotalo P A, Veinot J P, Jabi M
Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Arch Pathol Lab Med. 2000 Apr;124(4):609-13. doi: 10.5858/2000-124-0609-HMCIML.
We describe a patient with hyperplastic mesothelial cells localized to mediastinal lymph node sinuses. These mesothelial cells were originally misdiagnosed as metastatic carcinoma, and the patient received radiotherapy. Histologic review, immunohistochemistry, and ultrastructural studies confirmed mesothelial cell origin. These nodal mesothelial cells were associated with pericardial and pleural effusions. Extranodal lymphatics also contained hyperplastic mesothelial cells, confirming their mode of lymphatic transport to node sinuses. This finding supports the theory that hyperplastic mesothelial cells derive from reactive serosal mesothelium and are dislodged into draining lymphatics. This is the first report, to our knowledge, that demonstrates the pathogenetic significance of this lymphatic transport mechanism. Awareness of intralymphatic and nodal benign hyperplastic mesothelial cells and their mimicry of invasive malignant neoplasms is important for accurate diagnoses and appropriate therapy.
我们描述了一名患者，其增生的间皮细胞定位于纵隔淋巴结窦。这些间皮细胞最初被误诊为转移性癌，该患者接受了放射治疗。组织学检查、免疫组织化学和超微结构研究证实了间皮细胞起源。这些淋巴结间皮细胞与心包和胸腔积液有关。结外淋巴管也含有增生的间皮细胞，证实了它们向淋巴结窦的淋巴转运模式。这一发现支持了增生性间皮细胞来源于反应性浆膜间皮并脱落至引流淋巴管的理论。据我们所知，这是第一份证明这种淋巴转运机制的致病意义的报告。认识到淋巴管内和淋巴结内良性增生性间皮细胞及其对侵袭性恶性肿瘤的模仿对于准确诊断和适当治疗很重要。
