Histopathology and enhanced detection of tumor invasion of peritoneal membranes

Abstract

Tumor invasion of the peritoneal membrane may have an adverse prognostic significance, but its histopathologic features can be diagnostically difficult to recognize. We observed that local peritoneal injury associated with tumor invasion is characterized by activation and proliferation of serosal stromal cells that express cytokeratin, a characteristic property of injured serosal membranes that may have diagnostic utility. To explore this, we examined 120 primary tumors of the gastrointestinal tract and pancreaticobiliary system using cytokeratin and elastic stains to assess for tumor invasion of peritoneal membranes. Peritoneal invasion by tumor was associated with retraction, splaying, and destruction of the elastic lamina and proliferation of keratin-expressing stromal cells of serosal membranes. All 82 peritoneal invasive tumors were characterized by neoplastic cells that invaded the elastic lamina and the serosal connective tissue with neoplastic cells that abutted or were surrounded by keratin-positive stromal cells, whereas all 38 tumors limited to the subserosa showed none of these features. The diagnosis of tumor invasion of peritoneal membranes is enhanced by the combined use of cytokeratin and elastic stains, which in turn would enable better histopathologic correlation with patient treatment and outcome.

Mesothelial-to-Mesenchymal Transition Contributes to the Generation of Carcinoma-Associated Fibroblasts in Locally Advanced Primary Colorectal Carcinomas

“…For these molecules, the immunostaining was less intense than that observed for cytokeratins and calretinin. Similar expression of mesothelial markers by subserosal fibroblasts, including CAFs, has been reported in a few other studies where pathologists are adviced not to confuse cytokeratin-positive fibroblasts for neoplastic cells [27][28][29]. In addition to cytokeratins, Chen J.H.…”

“…In addition to cytokeratins, Chen J.H. and Borges M. [29] describe the subserosal expression of other mesothelial markers as well. For these authors, such expression is evident, but it is not interpreted as a MMT process.…”

Assessment of Elastic Laminal Invasion Contributes to an Objective pT3 Subclassification in Colon Cancer

“…Therefore, our data revealed that more adequate pathologic criteria of pT4a is further required. Recently, utility of CK7 which highlight mesothelial cells was reported to be useful to detect pT4a in colon cancer, and further investigation would be required 31 . As for 2 inconsistent negative data as a prognostic factor of ELI, one performed elastic stain only in 47 of 290 cases, and another adopted special elastic stain.…”

“…Recently, utility of CK7 which highlight mesothelial cells was reported to be useful to detect pT4a in colon cancer, and further investigation would be required. 31 As for 2 inconsistent negative data as a prognostic factor of ELI, one performed elastic stain only in 47 of 290 cases, and another adopted special elastic stain. Routine use of elastic stain, and EVG or modified resorcine-fuchsin method for elastic stain is strongly recommended.…”