Best Cases from the AFIP

Abstract

Editor's Note.-Everyone who has taken the course in radiologic pathology at the Armed Forces Institute of Pathology (AFIP) remembers bringing beautifully illustrated cases for accession to the Institute. In recent years, the staff of the Department of Radiologic Pathology has judged the "best cases" by organ system, and recognition is given to the winners on the last day of the class. With each issue of RadioGraphics, one or more of these cases are published, written by the winning resident. Radiologicpathologic correlation is emphasized, and the causes of the imaging signs of various diseases are illustrated.

Benign multicystic peritoneal mesothelioma: a case report

“…It is often diffuse and shows a marked predilection for the surfaces of the pelvic viscera [1-8]. In our case report, the lesion was solitary and situated in the left abdomen.…”

“…It is an intermediate-grade tumor, among the benign adenomatoid tumors of the peritoneum and the more common malignant asbestos-related peritoneal mesothelioma. It is not related to prior asbestos exposure and may recur locally [1-11]. …”

“…The presenting symptoms are chronic or intermittent lower abdominal or pelvic pain, tenderness, or distension with an abdominal or pelvic mass and, rarely, dyspareunia, constipation and urinary hesitancy and/or frequency. Women with this lesion often have a history of prior pelvic surgery, endometriosis or pelvic inflammatory disease [1-3,5,7-10]. …”

“…The watery serous content has low signal intensity on T1-weighted images and intermediate-to-high signal intensity on T2-weighted images. Septal enhancement has been reported [1,2]. …”

“…The cystic component in cystic adenomatoid tumor is usually accompanied by a recognizable solid component. Malignant neoplasms are suggested by ancillary signs such as intramural nodules, ascites, necrosis or peritoneal carcinomatosis, and the source organ can usually be identified [1,5-7,9,10]. …”