Soltermann Alex, Pache Jean-Claude, Vogt Peter
Institute of Surgical Pathology, University Hospital Zurich, Zurich;
Rare Tumors. 2011 Oct 21;3(4):e52. doi: 10.4081/rt.2011.e52. Epub 2011 Dec 21.
Deciduoid mesothelioma is a rare variant of the epithelioid histotype spectrum, resembling decidua of gravid uterus. It is found in the peritoneum of young women, but also in the pleura of elderly people. Histotype plasticity from epithelioid to sarcomatoid mesothelioma may be considered as epithelial-mesenchymal transition (EMT). A full autopsy was performed and mesothelioma infiltrates were analysed by immunohistochemistry. The metastasis of an epithelioid pleural mesothelioma to a hyperplastic polyp of the stomach is presented in this autopsy case. Deciduoid morphology increased during tumour progression and metastasis. The increase in eosinophilic cytoplasm correlated with the upregulation of the intermediate filament vimentin. High expression of vimentin was found in both central and superficial periglandular regions of the polyp. High vimentin expression also can occur in epithelioid rather than sarcomatoid differentiation. Thus, although vimentin is considered to be the major EMT marker, additional pathways must regulate its expression.
蜕膜样间皮瘤是上皮样组织学类型谱中的一种罕见变体，类似于妊娠子宫的蜕膜。它见于年轻女性的腹膜，但也见于老年人的胸膜。从上皮样间皮瘤到肉瘤样间皮瘤的组织学类型可塑性可被视为上皮-间质转化（EMT）。进行了全面尸检，并通过免疫组织化学分析了间皮瘤浸润情况。本尸检病例展示了一例上皮样胸膜间皮瘤转移至胃增生性息肉。在肿瘤进展和转移过程中，蜕膜样形态增加。嗜酸性细胞质的增加与中间丝波形蛋白的上调相关。在息肉的中央和浅表腺周区域均发现波形蛋白高表达。波形蛋白高表达也可发生在上皮样而非肉瘤样分化中。因此，尽管波形蛋白被认为是主要的EMT标志物，但必须有其他途径调节其表达。
