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What's Your Diagnosis?
The diagnosis
We present a case of benign multicystic mesothelioma with extensive involvement of the abdominal and pelvic cavities in a male patient. Benign multicystic mesothelioma is a rare tumor most frequently localized to the pelvic peritoneal surface. Patients are usually women of reproductive age without a history of asbestos exposure. The gross appearance is typically multiple translucent membranous cysts that are grouped together to form a mass or discontinuously studding the peritoneal surface. Microscopically, the cystic spaces are lined by mesothelial cells expressing markers such as calretinin. The major differential diagnosis is cystic lymphangioma, in which cystic spaces are lined by endothelial cells. Preoperative diagnosis by fine-needle aspiration cytology has been described in the literature. Cytology shows monomorphous cells with mesothelial features in a clean background.1 The disease course is usually indolent, but local recurrence after operative intervention is common.2,3
References
1. Devaney, K., Kragel, P.J., Devaney, E.J. Fine-needle aspiration cytology of multicystic mesothelioma. Diagn Cytopathol. 1992 Jan;8:68-72.
2. Ross, M.J., Welch, W.R., Scully, R.E. Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). Cancer. 1989 Sep;64:1336-46.
3. Weiss, S.W. Tavassoli, F.A. Multicystic mesothelioma (An analysis of pathologic findings and biologic behavior in 37 cases). Am J Surg Pathol. 1988 Oct;12:737-46.
The diagnosis
We present a case of benign multicystic mesothelioma with extensive involvement of the abdominal and pelvic cavities in a male patient. Benign multicystic mesothelioma is a rare tumor most frequently localized to the pelvic peritoneal surface. Patients are usually women of reproductive age without a history of asbestos exposure. The gross appearance is typically multiple translucent membranous cysts that are grouped together to form a mass or discontinuously studding the peritoneal surface. Microscopically, the cystic spaces are lined by mesothelial cells expressing markers such as calretinin. The major differential diagnosis is cystic lymphangioma, in which cystic spaces are lined by endothelial cells. Preoperative diagnosis by fine-needle aspiration cytology has been described in the literature. Cytology shows monomorphous cells with mesothelial features in a clean background.1 The disease course is usually indolent, but local recurrence after operative intervention is common.2,3
References
1. Devaney, K., Kragel, P.J., Devaney, E.J. Fine-needle aspiration cytology of multicystic mesothelioma. Diagn Cytopathol. 1992 Jan;8:68-72.
2. Ross, M.J., Welch, W.R., Scully, R.E. Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). Cancer. 1989 Sep;64:1336-46.
3. Weiss, S.W. Tavassoli, F.A. Multicystic mesothelioma (An analysis of pathologic findings and biologic behavior in 37 cases). Am J Surg Pathol. 1988 Oct;12:737-46.
The diagnosis
We present a case of benign multicystic mesothelioma with extensive involvement of the abdominal and pelvic cavities in a male patient. Benign multicystic mesothelioma is a rare tumor most frequently localized to the pelvic peritoneal surface. Patients are usually women of reproductive age without a history of asbestos exposure. The gross appearance is typically multiple translucent membranous cysts that are grouped together to form a mass or discontinuously studding the peritoneal surface. Microscopically, the cystic spaces are lined by mesothelial cells expressing markers such as calretinin. The major differential diagnosis is cystic lymphangioma, in which cystic spaces are lined by endothelial cells. Preoperative diagnosis by fine-needle aspiration cytology has been described in the literature. Cytology shows monomorphous cells with mesothelial features in a clean background.1 The disease course is usually indolent, but local recurrence after operative intervention is common.2,3
References
1. Devaney, K., Kragel, P.J., Devaney, E.J. Fine-needle aspiration cytology of multicystic mesothelioma. Diagn Cytopathol. 1992 Jan;8:68-72.
2. Ross, M.J., Welch, W.R., Scully, R.E. Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). Cancer. 1989 Sep;64:1336-46.
3. Weiss, S.W. Tavassoli, F.A. Multicystic mesothelioma (An analysis of pathologic findings and biologic behavior in 37 cases). Am J Surg Pathol. 1988 Oct;12:737-46.
What's Your Diagnosis?
What's Your Diagnosis?
What's Your Diagnosis?
BY SHAN-CHI YU, MD, CHIH-HORNG WU, MD, AND HSIN-YI HUANG, MD. Published previously in Gastroenterology (2012;143:1156, 1140).
The cystic lesions and appendix were resected under the clinical impression of pseudomyxoma peritonei.
There were multiple, thin-walled, cystic tumors containing clear fluid throughout the abdominal and pelvic cavities.
The cysts were lined by a single layer of flattened or cuboidal cells, which were positive for calretinin (Figures D) and negative for CD31 (an endothelial marker). A carcinoid tumor was incidentally found at the appendix.
