Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, Vermont, USA.
Department of Pathology, Duke University Health System, Durham, North Carolina, USA.
J Clin Pathol. 2018 Nov;71(11):971-974. doi: 10.1136/jclinpath-2018-205099. Epub 2018 May 23.
Florid mesothelial hyperplasia is known to result from endometriosis. Well-differentiated papillary mesothelioma and multiloculated peritoneal inclusion cysts have also been described in women with endometriosis. To our knowledge, peritoneal diffuse malignant mesothelioma (MM) arising in the setting of endometriosis has not been reported. The purpose of this study is to report the clinicopathological characteristics of women with MM and endometriosis.
The surgical pathology files of a tertiary academic medical centre and the consultation files of one of the study authors were reviewed for cases of MM in females with and without endometriosis.
Six women with MM and endometriosis ranging in age from 29 to 55 years (median=45 years) were identified. All had peritoneal MM and endometriosis involving the peritoneum and/or adnexa. Five had epithelioid MM and one had biphasic MM. Two had paraoccupational exposure to asbestos. The median age of women with MM and endometriosis (44.5 years) was significantly less than the median age of cases without endometriosis (58.0 years) (p value=0.01).
To our knowledge, this is the first report of MM in women with endometriosis. Interestingly, MM in the setting of endometriosis has only been observed in the peritoneum and not in other serosal cavities. The findings in the present study suggest that chronic serosal inflammation secondary to endometriosis may be an inducing factor in rare cases of MM of the peritoneum.
已知子宫内膜异位症可导致间皮细胞增生。在患有子宫内膜异位症的女性中，也已描述了分化良好的乳头状间皮瘤和多房性腹膜包涵囊肿。据我们所知，在子宫内膜异位症背景下发生的腹膜弥漫性恶性间皮瘤（MM）尚未见报道。本研究旨在报告患有 MM 和子宫内膜异位症的女性的临床病理特征。
回顾了一家三级学术医疗中心的外科病理学档案和一位研究作者的咨询档案，以寻找患有 MM 和不患有子宫内膜异位症的女性病例。
共确定了 6 例年龄在 29 岁至 55 岁之间（中位数=45 岁）的患有 MM 和子宫内膜异位症的女性。所有患者均患有腹膜 MM 和累及腹膜和/或附件的子宫内膜异位症。5 例为上皮样 MM，1 例为双相 MM。其中 2 例有职业性接触石棉的情况。患有 MM 和子宫内膜异位症的女性的中位年龄（44.5 岁）明显低于无子宫内膜异位症的病例的中位年龄（58.0 岁）（p 值=0.01）。
据我们所知，这是首次报道子宫内膜异位症女性中发生 MM。有趣的是，子宫内膜异位症背景下的 MM 仅观察到在腹膜中，而不在其他浆膜腔中。本研究的结果表明，子宫内膜异位症引起的慢性浆膜炎症可能是腹膜 MM 的罕见病例的诱发因素。
