Pongsuvareeyakul Tip, Saipattranusorn Kanokkan, Sukpan Kornkanok, Suprasert Prapaporn, Khunamornpong Surapan
Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Department of Pathology, Chonburi Hospital, Chonburi 20000, Thailand.
Diagnostics (Basel). 2023 Mar 15;13(6):1119. doi: 10.3390/diagnostics13061119.
The clear-cell variant of epithelioid mesothelioma is an extremely rare neoplasm of the peritoneum. It shares histomorphologic features overlapping with a wide variety of tumors including carcinomas and other non-epithelial neoplasms. The diagnosis of peritoneal clear-cell mesothelioma is not always straightforward, despite known immunohistochemistry (IHC) markers. Due to its rarity, this entity may be diagnostically confused with other clear-cell neoplasms, particularly in intraoperative frozen sections. Here, we present a case of clear-cell mesothelioma originating in the uterine serosa that was initially misdiagnosed as clear-cell adenocarcinoma in the intraoperative frozen section. Microscopically, the tumor showed diffuse tubulocystic spaces of variable size lined by clear cells with moderate nuclear atypia. Immunohistochemical staining confirmed the diagnosis of clear-cell mesothelioma. Recognition of this entity, albeit rare, is important as the diagnosis may significantly affect the management considerations. The judicious use of an IHC panel helps to distinguish this tumor from other mimickers.
上皮样间皮瘤的透明细胞变体是一种极其罕见的腹膜肿瘤。它具有与多种肿瘤（包括癌和其他非上皮性肿瘤）重叠的组织形态学特征。尽管有已知的免疫组织化学（IHC）标志物，但腹膜透明细胞间皮瘤的诊断并不总是一目了然。由于其罕见性，该实体在诊断上可能与其他透明细胞肿瘤混淆，尤其是在术中冰冻切片时。在此，我们报告一例起源于子宫浆膜的透明细胞间皮瘤病例，该病例在术中冰冻切片时最初被误诊为透明细胞腺癌。显微镜下，肿瘤表现为大小不一的弥漫性微管囊状间隙，内衬透明细胞，核异型性中等。免疫组织化学染色确诊为透明细胞间皮瘤。认识到这一实体，尽管罕见，但很重要，因为诊断可能会显著影响治疗决策。明智地使用免疫组织化学检测组合有助于将这种肿瘤与其他相似肿瘤区分开来。
