Epithelioid Mesothelioma of Peritoneum Masquerading as Peritoneal Carcinomatosis.

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Jyotsna Naresh Bharti
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引用次数: 0

Abstract

Introduction: Mesothelioma is an insidious neoplasm that develops from mesothelial cells. About 80% of mesotheliomas originate in the pleural cavity. Other sites where it has been reported are the peritoneal cavity, tunica vaginalis, and the pericardium.

Case presentation: A 45-year-old female complained of abdominal distention and pain for three months. There was a significant weight loss of approximately 15 kg in the past three months, and there was no family history of any malignancy, tuberculosis, substance abuse, or asbestosis exposure. Physical examination revealed signs of muscle wasting, loss of subcutaneous fat, and hollowing of the eye sockets. There was pitting edema in the bilateral lower limbs; per abdomen examination revealed abdominal distension with umbilicus in the midline. No visible peristalsis or dilated veins were seen all over the abdomen. Hernial sites were normal. Gross ascites were present, and no organomegaly, definitive mass, or lump was palpable. The dull note was heard all over the abdomen, and fluid thrill was noted on percussion. Bowel sounds were normal on auscultation. The ascitic fluid examination revealed the presence of atypical cells. An omentectomy was done and it was sent for histopathological examination.

Conclusion: The specimen of omentectomy was in multiple fragments and measured 17x16x3cm; a few of the fragments were nodular, soft to firm on palpation. The cut section of mass was gray and white with areas of necrosis. Microscopic examination showed sheets of malignant cells. These tumor cells were immunoreactive to EMA, cytokeratin, vimentin, calretinin, WT-1, and D2-40 and immune negative to desmin (highlighting only the entrapped reactive mesothelial cells), inhibin, BerEP4, TTF-1, CD 68, napsin, ER, CEA, CDX2, PR, PAX-8, and SALL4. Ki67 labelling index was 15%. The features were of epithelioid mesothelioma.

伪装成腹膜癌的腹膜上皮样间皮瘤
导言:间皮瘤是一种由间皮细胞发展而来的隐匿性肿瘤。大约80%的间皮瘤起源于胸膜腔。其他有报道的部位包括腹腔、阴道外膜和心包:一名 45 岁的女性主诉腹部胀痛三个月。在过去的三个月中,她的体重明显下降了约 15 公斤,而且没有任何恶性肿瘤、结核病、药物滥用或石棉沉滞症的家族史。体格检查显示,患者肌肉萎缩,皮下脂肪减少,眼窝凹陷。双下肢出现点状水肿;腹部检查显示腹部膨胀,脐部位于中线。腹部各处未见明显蠕动或扩张的静脉。疝气部位正常。腹水明显,未触及器官肿大、明确肿块或包块。腹部各处均可听到钝响,叩诊时可听到液体震颤。听诊肠鸣音正常。腹水检查显示存在非典型细胞。患者接受了网膜切除术,并送去进行组织病理学检查:网膜切除术的标本为多块碎片,大小为 17x16x3厘米;其中几块碎片呈结节状,触诊时由软到硬。肿块切面呈灰白色,有坏死区域。显微镜检查显示有成片的恶性细胞。这些肿瘤细胞对EMA、细胞角蛋白、波形蛋白、钙凝蛋白、WT-1和D2-40呈免疫反应,对desmin(仅突出显示夹杂的反应性间皮细胞)、inhibin、BerEP4、TTF-1、CD 68、napsin、ER、CEA、CDX2、PR、PAX-8和SALL4呈免疫阴性。Ki67标记指数为15%。其特征为上皮样间皮瘤。
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来源期刊
CiteScore
2.60
自引率
0.00%
发文量
246
审稿时长
1 months
期刊介绍: Current Medical Imaging Reviews publishes frontier review articles, original research articles, drug clinical trial studies and guest edited thematic issues on all the latest advances on medical imaging dedicated to clinical research. All relevant areas are covered by the journal, including advances in the diagnosis, instrumentation and therapeutic applications related to all modern medical imaging techniques. The journal is essential reading for all clinicians and researchers involved in medical imaging and diagnosis.
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