Primary epithelial malignant mesothelioma of the pericardium with deciduoid features: Cytohistologic and immunohistochemical study

Reis‐Filho, Jorge S.; Pope, Leonora Zozula Blind; Milanezi, Fernanda; Balderrama, Cynthia M.S.R.; Serapião, Maria José; Schmitt, Fernando

doi:10.1002/dc.10068.abs

Cited by 13 publications

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“…8,9,23,24 Mitotic activity has been documented as being variable and, although some reports have mentioned that the tumor had high mitotic activity and the presence of atypical mitoses, [2][3][4][5]8 others have indicated that only rare or few mitoses were present. 11,13,14,21,24 In addition to the previously mentioned morphological features, some of the published reports have included other findings that, although uncommon, can also occur in deciduoid mesotheliomas. These include the presence of focal areas in which the cells present foamy, 18 vacuolated 10,11 or clear cytoplasm, 15,19 prominent intracytoplasmic lumina, 3,5,15 focal rhabdoid changes, 7,19 and mucinous or myxoid stroma.…”

Section: Discussionmentioning

confidence: 99%

“…5 In these reports, however, it was demonstrated that mesotheliomas with deciduoid features can also originate in the pleura, occur in elderly men, and be associated with asbestos exposure. Since then, several other cases, mostly individual case reports, have been published [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] (Table 1). Although patient survival in many of the published cases has been short and limited to a few months after diagnosis, thus suggesting that deciduoid mesotheliomas have an aggressive clinical course, patients with long survival …”

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Deciduoid mesothelioma: report of 21 cases with review of the literature

Ordóñez

2012

Modern Pathology

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Deciduoid mesothelioma is a rare variant of epithelioid mesothelioma that was initially considered to occur exclusively in the peritoneum of young women who had no history of asbestos exposure and to be characterized by an aggressive clinical course, but it was later demonstrated that this tumor could also occur in the pleura of older men and women who had been exposed to asbestos. Some subsequent studies have also indicated that the clinical course is no different from that of conventional epithelioid mesothelioma. Herein are reported 21 cases of deciduoid mesothelioma that were investigated using a large panel of immunohistochemical markers, 9 of which were also studied by electron microscopy. Fifteen of the patients were male and 6 were female (mean age, 60 years). Seventeen of the cases originated in the pleura and four in the peritoneum. Histologically, all of the cases were composed of large, polygonal or ovoid cells with well-defined cell borders, dense eosinophilic cytoplasm, and single or multiple nuclei. In some cases, the cells exhibited a wide variation in their size and shape, frequent loss of cell cohesion, marked nuclear atypia, and high mitotic activity (45 per 10 HPF); whereas, in others, the cells were more cohesive, less pleomorphic, and the mitotic activity low. As the survival of patients in the first group of cases was shorter (mean, 7 months), when compared with that of the latter (mean, 23 months), it is concluded that the differences in prognosis reported in deciduoid mesothelioma are due to the existence of a high-grade subgroup that presents highly aggressive clinical behavior. Therefore, when a high-grade deciduoid mesothelioma is present, it should be reported as it can significantly affect prognosis and treatment. The use of immunohistochemistry and electron microscopy in assisting in the differential diagnosis of deciduoid mesothelioma is also discussed.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Deciduoid mesothelioma: report of 21 cases with review of the literature

Ordóñez

2012

Modern Pathology

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“…The clinical history of the patient, the lack of mitosis in decidual cells, and the vimentin and PR positivity and keratin, calretinin, HBME-1 antibody negativity on immunohistochemical analysis support peritoneal deciduosis. Cytokeratin 5/6 and calretinin positivity support deciduoid mesothelioma, the keratin positivity metastatic carcinoma and the HMB-45 and S-100 protein positivity support malignant melanoma (10,12,13).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-related peritoneal ectopic decidua (deciduosis): morphological and clinical evaluation

Bolat

Canpolat²,

Tarım³

2012

TJPATH

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Objective: Ectopic decidual reaction (deciduosis) can be seen rarely on the peritoneum during laparotomy for a cesarean section for pregnancy, in addition to the ovary and cervix. The aim of this study was to evaluate the clinical, histopathological, immunohistochemical characteristics of ectopic decidua cases that were incidentally found in the peritoneum during a cesarean section. Material and Method:A total of seven cases where decidualization was found in the peritoneal biopsy taken during pregnancy at the Baskent University Adana Research and Medical Center, Department of Pathology were included in this study. The clinical features of the cases were obtained from their clinical folders. The morphological findings were recorded and the peritoneal biopsies were analyzed with keratin Pan Ab-1, calretinin, vimentin, HMB-45 and progesterone receptor antibody for immunohistochemical analysis. Results:The mean age for the seven cases was 36±4.16. The gestational age was 33 to 39 (mean 37.2) weeks. Microscopic evaluation revealed decidualized cells that were large polygonal and eosinophilic, some with vacuolated cytoplasm, that formed small nodules under the mesothelium of the peritoneum in all cases. Immunohistochemical staining showed positive staining of the cell cytoplasm with vimentin and positive staining of the cell nucleus with the progesterone receptor antibody in the decidual cells. Calretinin, keratin and HMB-45 stains were negative. Conclusion:Pregnancy-related peritoneal deciduosis develops with the effect of progesterone in pregnancy. It disappears without complication in the postpartum period. Immunohistochemistry may help the differential diagnosis of peritoneal deciduosis where problems are experienced differentiating the case from malignant mesothelioma or metastatic tumor.

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“…Although the original publication reported that malignant deciduoid mesothelioma arises most commonly in the peritoneum of young female cases, recent publications revealed that it may also occur in the pleura or pericardium of elderly male and female subjects, with or without asbestos exposure. [3][4][5][6][7][8][9][10][11][12] The pronounced anaplastic morphology of deciduoid mesothelioma requires differential diagnosis from other malignant tumors.…”

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confidence: 99%