Mery Éliane, Hommell-Fontaine Juliette, Capovilla Mathieu, Chevallier Anne, Bibeau Frédéric, Croce Sabrina, Dartigues Peggy, Kaci Rachid, Lang-Averous Gerlinde, Laverriere Marie-Hélène, Leroux-Broussier Agnès, Poizat Flora, Robin Nina, Valmary-Degano Séverine, Verriele-Beurrier Véronique, Villeneuve Laurent, Isaac Sylvie
Département d'anatomie pathologique, institut Claudius-Regaud, 20, 24, rue du Pont-Saint-Pierre, 31052 Toulouse, France.
Service d'anatomie pathologique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France.
Ann Pathol. 2014 Feb;34(1):26-33. doi: 10.1016/j.annpat.2014.01.004. Epub 2014 Feb 11.
Peritoneal malignant mesothelioma is a rare tumor, less common than its pleural counterpart. It develops from the mesothelial cells overlying peritoneum and preferentially occurs in male, with an average age ranging from 47 to 60.5 years. Asbestos whose impact is less strong than in pleural mesothelioma, SV 40 virus, chronic peritonitis could be implicated as factors favoring the development of peritoneal mesothelioma. Clinical symptoms are not specific, and the imagery remains little or not contributive. The 2004 WHO classification recognizes 3 different types, which differ in terms of presentation and prognosis: diffuse epithelioid mesothelioma (the most common), sarcomatoid mesothelioma and biphasic mesothelioma. Many variants are described within these groups. Immunohistochemistry is mandatory to affirm or disprove peritoneal malignant mesothelioma diagnosis, based on a panel of antibodies divided in positive markers and negative markers. Indeed an accurate diagnosis is necessary to define a therapeutic strategy more and more frequently based on the combination of radical surgery and hyperthermic intra peritoneal chemotherapy. Such an approach significantly improves the prognosis of these aggressive diseases.
腹膜恶性间皮瘤是一种罕见肿瘤，比胸膜恶性间皮瘤更少见。它起源于覆盖腹膜的间皮细胞，好发于男性，平均发病年龄在47至60.5岁之间。石棉对其影响不如对胸膜间皮瘤的影响大，SV40病毒、慢性腹膜炎可能是促使腹膜间皮瘤发生的因素。临床症状不具特异性，影像学检查作用不大或几乎没有帮助。2004年世界卫生组织分类认可3种不同类型，它们在表现和预后方面存在差异：弥漫性上皮样间皮瘤（最常见）、肉瘤样间皮瘤和双向性间皮瘤。在这些类型中还描述了许多变异型。基于一组分为阳性标志物和阴性标志物的抗体，免疫组化对于肯定或否定腹膜恶性间皮瘤的诊断是必需的。事实上，准确诊断对于越来越多地基于根治性手术和腹腔内热化疗联合的治疗策略的制定是必要的。这种方法显著改善了这些侵袭性疾病的预后。
