Kim Moonsik, Kim Hyun-Soo
Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
In Vivo. 2019 Mar-Apr;33(2):633-642. doi: 10.21873/invivo.11521.
BACKGROUND/AIM: Well-differentiated papillary mesothelioma (WDPM) is histologically characterized by papillary architecture with fibrovascular cores, lined by bland mesothelial cells. We recently experienced a case of WDPM associated with multiple peritoneal inclusion cysts, which prompted us to initiate a comprehensive review of previously diagnosed WDPM cases.
The clinicopathological characteristics and immunophenotype of 12 cases of peritoneal WDPM were investigated using a review of electronic medical records, pathological examination, and immunostaining.
The patients' ages ranged from 23 to 75 years. No patient had endometriosis or a previous history of asbestos exposure. Ten tumors were detected incidentally during surgery for other causes. Most tumors appeared as a small, single nodule on the peritoneal surface, but in three cases, WDPM presented as multiple lesions. All but one patient had no symptoms. All the patients examined are still well without postoperative recurrence. Histologically, all cases demonstrated typical papillary architecture with fibrovascular cores. The mesothelial cells lining the papillae consisted mostly of single row of cells, although areas of proliferation to multiple layers were observed in a few cases. Their nuclei appeared bland, but two cases exhibited mild nuclear atypia and prominent nucleoli. Immunostaining revealed that the mesothelial cells were positive for D2-40, cytokeratin 5/6, cytokeratin 7, and Wilms' tumor 1.
We herein demonstrated the clinicopathological characteristics of peritoneal WDPMs. WDPM has distinct pathological features. Although all cases we examined were uneventful after surgery, further surveillance is recommended since the biological behavior of WDPM is still uncertain.
背景/目的：高分化乳头状间皮瘤（WDPM）的组织学特征为具有纤维血管轴心的乳头状结构，内衬温和的间皮细胞。我们最近遇到一例与多个腹膜包涵囊肿相关的WDPM病例，这促使我们对先前诊断的WDPM病例进行全面回顾。
通过查阅电子病历、病理检查和免疫染色，对12例腹膜WDPM的临床病理特征和免疫表型进行了研究。
患者年龄在23至75岁之间。所有患者均无子宫内膜异位症或石棉接触史。10例肿瘤在因其他原因进行手术时偶然发现。大多数肿瘤表现为腹膜表面的单个小结节，但有3例WDPM表现为多发病变。除1例患者外，所有患者均无症状。所有接受检查的患者术后均情况良好，无复发。组织学上，所有病例均表现为具有纤维血管轴心的典型乳头状结构。乳头内衬的间皮细胞大多由单层细胞组成，不过少数病例可见细胞增殖至多层。细胞核看起来温和，但有2例表现出轻度核异型性和明显核仁。免疫染色显示间皮细胞D2-40、细胞角蛋白5/6、细胞角蛋白7和肾母细胞瘤1呈阳性。
我们在此展示了腹膜WDPM的临床病理特征。WDPM具有独特的病理特征。尽管我们检查的所有病例术后均无异常，但由于WDPM的生物学行为仍不确定，建议进一步监测。
