Chand Momal Tara, Edens Jacob, Lin Tayson, Anderson Ian, Berri Richard
Ascension St. John Hospital, Anatomical & Clinical Pathology. Detroit, MI, USA.
Ascension ST John Hospital, Department of Pathology. Detroit, MI, USA.
Autops Case Rep. 2020 Jun 5;10(3):e2020159. doi: 10.4322/acr.2020.159.
Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumor diagnosed predominantly in pre-menopausal women. Associated risk factors include endometriosis and pelvic inflammatory disease in women, and prior abdominal surgery in both genders. To date, the pathogenesis of this disease remains controversial with possible etiologies, including a neoplastic versus a reactive process. Given the risk factors, some authors believe that this disease is secondary to a reactive process. However, because some studies describe cases where there is no prior surgical history or inflammatory milieu present, and because of this entity's predilection for recurrence, some authors believe the origin to be neoplastic. Some genetic and familial associations have also been reported. Malignant transformation is extremely rare, with only two cases reported in the literature, despite the recurrence potential. Like the etiology, the name of this entity is also controversial. Some authors prefer the term "peritoneal inclusion cyst (PCM)" instead of "benign cystic mesothelioma" and argue that the term mesothelioma should only be used when there is evidence of atypia. Most cases of BMPM are discovered incidentally. Others reflect sequela of tumor mass effect. It appears intra-operatively as large, multi-focal, cystic lesions in the peritoneal and pelvic cavity. Diagnosis is achieved through surgical sampling with histopathological examination. Immunobiologically, BMPM exhibits multiple small cystic spaces with flattened lining containing calretinin positive cells without atypical features, mitotic figures, or tissue invasion. Treatment includes cytoreductive surgery. Here we present a case of BMPM in a 60-year-old male - a rare disease in an uncommon patient population.
良性多囊性腹膜间皮瘤（BMPM）是一种罕见的腹膜肿瘤，主要在绝经前女性中诊断出来。相关危险因素包括女性的子宫内膜异位症和盆腔炎，以及男女双方既往的腹部手术史。迄今为止，这种疾病的发病机制仍存在争议，可能的病因包括肿瘤性过程与反应性过程。鉴于这些危险因素，一些作者认为这种疾病是继发于反应性过程。然而，由于一些研究描述了没有既往手术史或炎症环境的病例，并且由于该实体易于复发，一些作者认为其起源是肿瘤性的。也有一些遗传和家族性关联的报道。尽管有复发的可能性，但恶性转化极为罕见，文献中仅报道了两例。与病因一样，该实体的名称也存在争议。一些作者更喜欢使用“腹膜包涵囊肿（PCM）”这个术语，而不是“良性囊性间皮瘤”，并认为只有在有异型性证据时才应使用间皮瘤这个术语。大多数BMPM病例是偶然发现的。其他病例则反映了肿瘤肿块效应的后遗症。它在手术中表现为腹膜和盆腔内的大的、多灶性的囊性病变。通过手术取样和组织病理学检查来实现诊断。在免疫生物学上，BMPM表现为多个小的囊性间隙，内衬扁平，含有钙视网膜蛋白阳性细胞，无异型性特征、有丝分裂象或组织侵袭。治疗包括减瘤手术。我们在此报告一例60岁男性的BMPM病例——这是一种在不常见患者群体中出现的罕见疾病。
