Papillary mesothelioma of the tunica vaginalis propria testis

Mikuz, Gregor; Höpfel-Kreiner, I

doi:10.1007/bf00431244

Cited by 26 publications

(16 citation statements)

References 10 publications

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“…11,13 To our knowledge, there have only been 11 well-documented cases reported as paratesticular 'well-differentiated papillary mesothelioma' to date. 3,6,8,12,[15][16][17][18][19][20][21] However, on the basis of microscopic descriptions and illustrations five had more complex areas within them, similar to the cases reported here. 6,12,16,18,20 Among the 11 cases, only one recurred and progressed to diffuse malignant mesothelioma.…”

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confidence: 79%

Mesothelioma of the tunica vaginalis: a series of eight cases with uncertain malignant potential

2010

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Well-differentiated papillary mesotheliomas have rarely been reported to involve the testis tunica vaginalis. While the classic histology of the originally described well-differentiated papillary mesotheliomas consisted of papillae lined by a single layer of bland cuboidal cells, more complex architectural patterns have been described. This report details our experience with eight paratesticular mesotheliomas that span the histological spectrum from classic well-differentiated papillary mesotheliomas to those with more complex patterns. We attempt to determine whether there are prognostic or immunohistochemical differences between these lesions and 28 diffuse malignant mesotheliomas. All cases had papillary/tubulopapillary in addition to more complex architectures (cribriform, condensed) and none showed evidence of invasion. Mitotic figures were present in seven cases and averaged 2.1 mitosis per 50 h.p.f. All cases showed r1% of positive cells staining for Ki-67 and p53, and only one case stained positive for GLUT-1 in comparison with 50% positivity for GLUT-1 in diffuse mesotheliomas. Of five patients with follow-up information of more than 1 year, three patients were alive at 2, 3 and 9 years, and two died of unknown causes at 5 and 47 years, suggesting that these lesions behave more indolently than typical malignant mesotheliomas of the tunica vaginalis. If these cases were diffuse malignant mesotheliomas, one would have expected at least some of the patients to have died of disease within a couple of years after diagnosis. However, detailed and long-term follow-up were not sufficiently available to reach definitive conclusions on the true biological behavior of these tumors. The morphological continuum noted between our cases and classic well-differentiated papillary mesotheliomas, combined with their immunohistochemical profile and indolent behavior, contrasts with that of diffuse malignant mesotheliomas. We propose that these tunica vaginalis mesotheliomas, which are more complex than the classic well-differentiated papillary mesotheliomas, and yet are not overtly histologically malignant, be classified as 'mesotheliomas of uncertain malignant potential'.

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confidence: 79%

Mesothelioma of the tunica vaginalis: a series of eight cases with uncertain malignant potential

2010

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“…Features include long, branching microvilli, abundant intracytoplasmic fibrils, desmosomes, and sparse intracytoplasmic organelles identical to those seen in mesotheliomas from the pleural cavities. 2,8,26,31,32 The differential diagnosis of paratesticular mesotheliomas is broad and includes both neoplastic and nonneoplastic conditions. Mesothelial hyperplasia, papillary serous neoplasms of the paratestis, tumors of the testicular collecting system (rete and epididymal carcinomas), and metastatic carcinomas may exhibit morphologic overlap with mesotheliomas of the tunica vaginalis.…”

Section: Discussionmentioning

confidence: 99%

The Immunohistochemical Profile of Malignant Mesotheliomas of the Tunica Vaginalis

Winstanley¹,

Landon²,

Berney³

et al. 2006

The American Journal of Surgical Pathology

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Malignant mesotheliomas of the testis arise from the tunica vaginalis, formed from the evagination of the abdominal peritoneum into the scrotum. The immunohistochemical profile of the tunica vaginalis and associated neoplasms is often extrapolated from thoracic studies. Testicular series are uncommon, usually derived from previous case studies and literature reviews. The immunohistochemical findings in 20 cases originally diagnosed as malignant mesotheliomas are presented. Archival testicular malignant mesothelioma specimens from 1959 to 2004 were collected from hospitals throughout the United Kingdom and from the authors' own archives. Hematoxylin and eosin-stained sections were reviewed, and selected sections from each case were then examined using an immunohistochemical panel of eight antibodies: calretinin (Zymed, 1:200), epithelial membrane antigen (EMA) (DAKO, 1:50), thrombomodulin (DAKO 1:5), CK7 (DAKO, 1:100), CK5-CK6 (DAKO, 1:10), BerEp4 (DAKO, 1:25), carcinoembryonic antigen (CEA) (DAKO, 1:10), and CK20 (DAKO, 1:100). The EnVision technique was used for all antibodies. Sections were reviewed independently by three pathologists. Electron microscopy was performed on selected cases. In all cases, the morphologic light microscopy criteria for a diagnosis of malignant mesothelioma were present. However, two tumors were later excluded from the study because of diffuse strong positive immunostaining with CK20 and BerEp4 and an ultrastructural appearance of adenocarcinoma. Of the remaining cases, 15 of 18 (83%) were purely epithelioid in type, showing a mixture of papillary, tubular, and solid patterns, and 3 of 18 (17%) showed a mixed sarcomatoid/epithelioid pattern. All cases were positive for calretinin and EMA (100%), 16 of 18 (89%) were positive for thrombomodulin, and 15 of 18 (83%) were positive for CK7. CK5-CK6 positivity was present in 13 of 18 (72%) but varied in strength and distribution; 2 of 18 (11%) were positive for BerEp4. All the cases were negative for CK20 and CEA. Four of the 18 cases were examined by electron microscopy, which revealed long thin microvilli supporting a diagnosis of malignant mesothelioma. This study has shown that the immunocytochemical profile of testicular malignant mesotheliomas is similar to those arising in the pleura, with diffuse positivity for calretinin, EMA, thrombomodulin, and CK7, and negative for CK20 and CEA. Focal weak positivity may be encountered with BerEp4. However, histopathologists should be aware of the variability in CK5-6 staining in testicular specimens when compared with pleural mesotheliomas.

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“…However, the presence of lipid accumulation in carcinoma cells has not been demonstrated thus far. Several cases of mesothelioma with a foamy cytoplasm have been reported [12][13][14][15][16][17] , and intracytoplasmic lipid accumulation was reported in 2 cases [12,14] . In addition, in a case of papillary mesothelioma of the peritoneum [14] , cytoplasmic vacuoles containing lipid droplets were located in the basal portion of tumour cells that showed papillary growth.…”

Section: Discussionmentioning

confidence: 99%

Cytoplasmic Lipid Accumulation Characteristic of the Cribriform Variant of Papillary Thyroid Carcinoma

Takada¹,

Hirokawa²,

Ito³

et al. 2017

Pathobiology

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Objective: The purpose of this study was to clarify the diagnostic significance of cytoplasmic lipid accumulation (CLIA) in the cribriform variant of papillary thyroid carcinoma (CV-PTC). Methods: We performed a histological, immunohistochemical, and cytological examination of 35 CV-PTC cases at the Kuma Hospital. CLIA was defined as bubble-like multivacuolation in cytoplasm with distinct cell border. We also examined 100 conventional PTC (con-PTC) cases as controls. Results: Histological analysis showed the presence of carcinoma cells with CLIA in 60.0% of CV-PTC and 5.0% of con-PTC cases. The vacuoles tended to distribute in the subnuclear portion of carcinoma cells showing papillary growth. They were positive for oil red O staining and adipophilin. The carcinoma cells without the vacuoles showed a subnuclear dot-like expression for adipophilin in CV-PTC cases, but not in the con-PTC cases. Cytological analysis showed CLIA in 17 (54.8%) of the 31 CV-PTC cases, but not in the con-PTC cases. Conclusion: This is the first study to report the presence of carcinoma cells with CLIA in CV-PTC. The subnuclear dot-like expression of adipophilin may be characteristic of CV-PTC. These findings might be related to degenerative changes occurring in CV-PTC.

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Papillary mesothelioma of the tunica vaginalis propria testis

Cited by 26 publications

References 10 publications

Mesothelioma of the tunica vaginalis: a series of eight cases with uncertain malignant potential

Mesothelioma of the tunica vaginalis: a series of eight cases with uncertain malignant potential

The Immunohistochemical Profile of Malignant Mesotheliomas of the Tunica Vaginalis

Cytoplasmic Lipid Accumulation Characteristic of the Cribriform Variant of Papillary Thyroid Carcinoma

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