Summary
A 29 year old woman, living in an area with a high level of asbestos exposure, developed the clinical features of peritoneal mesothelioma. The quantitative cytological features differed from those of other mesotheliomas described in the literature in that the tumor cells had a large amount of vacuolated cytoplasm and an extremely low N/C ratio, resulting in a “benign” appearance.
The ultrastructural study provided evidence for the production and accumulation of secretory products (mucolipids) by the tumor cells. Treatment with chemotherapy and radiation resulted in temporary remission, lasting for 20 months. However the patient then developed pulmonary involvement of the carcinomatose a form and pleural tumors. The cytological pattern and the morphometric features of the metastatic floating malignant mesothelial cells in the pleural fluid closely resembled those of the primary peritoneal tumor.
This case appears to be an example of secretory peritoneal mesothelioma with a bad prognosis, not withstanding the well-differentiated appearance of the tumor cells.
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References
Berge T, Gronthoff J (1965) Cytological diagnosis of malignant pleural mesothelioma. Acta Cytol 9:207–212
Boon ME, Tabbers-Boumeester ML (1980) Gynecological cytology, textbook and atlas. Macmillan Press, London, 82
Castor CW, Naylor B (1969) Characteristics of normal and malignant human mesothelial cells studies in vitro. Lab Invest 20:437–443
Churg AM Warnock ML (1979) Analysis of the cores of ferruginous (asbestos) bodies from the general population. III. Patients with environmental exposure. Lab Invest 40:662
Davis JMG (1974) Ultrastructure of human mesotheliomas. J Natl Cancer Inst 52:1715–1722
Domagala W, Woyke S (1975) Transmission and scanning electron microscopic studies of cells in effusions. Acta Cytol 19:214–224
Duve C de (1972) The lysosome in retrospect. In: Dingle, JT, Fell HB (eds) Lysosomes in: Biology and pathology, vol 1. North Holland Publishing Cy, Amsterdam/London, pp 3–43
Elmes PC, Simpson MJC (1976) The clinical aspects of mesothelioma. QJ Med 45:427–429
Godwin MC (1957) Diffuse mesotheliomas. Cancer 10:298–304
Gutman SI, Steinherz PG, Gray GF (1976) Malignant peritoneal mesothelioma in a child. Am J Dis Child 130:1268–1272
Hellstroem PE, Friman C, Teppo L (1977) Malignant mesothelioma of 17 years duration with high pleural fluid concentration of hyalonuraonate. Scand J Resp Dis 58:97–102
Hofner W (1979) Peritoneal mesothelioma with unusual metastases. Br J Radiol 52:1002–1004
Jones DEC, Silver D (1979) Peritoneal mesotheliomas. Surgery 86:556–560
Kannerstein M, Churg J (1977) Peritoneal mesothelioma. Hum Pathol 8:83–94
Kannerstein M, Mc Caughey WTE, Churg J, Selikoff IJ (1977) A critique of the criteria for the diagnosis of diffuse malignant mesothelioma. Mount Sinai J Med 44:485–493
Klempman S (1972) The exfoliative cytology of diffuse pleural mesothelioma. Cancer 31:691–696
Klima M, Spjut HJ, Seybold WD (1976) Diffuse malignant mesothelioma Am J Clin Pathol 65:585–599
Klima M, Gyorkey F (1977) Benign pleural lesions and malignant mesothelioma. Virchows Arch [Pathol Anat] 376:181–193
Kucuksu N, Thomas W, Ezdinli E (1976) Chemotherapy of diffuse mesothelioma. Cancer 37:1265–1274
Legrand M, Pariente R (1974) Ultrastructural study of pleural fluid in mesothelioma. Thorax 29:164–171
Letho VP, Virtanen I (1978) Intermediate (10nm) filaments in human malignant mesothelioma. Virchows Arch [Cell Pathol] 28:229–234
Lopes Cardozo P (1975) Atlas of clinical pathology, 's Hertogenbosch, Targa BV (eds) plate 271-2, p 304
Mann EH, Grosh JI, O'Donnell WD (1966) Mesothelioma associated with asbestosis. A report of three cases. Cancer 19:521–526
Mc Caughey WTE (1965) Criteria for diagnosis of diffuse mesothelial tumours. Ann NY Acad Sci 132:603–613
Moertel CG (1972) Peritoneal mesothelioma. Gastroenterology 63:346–351
Murad TM (1973) Electron microscopic studies of cells in pleural and peritoneal effusions. Acta Cytol 17:401–409
Naib ZM (1976) Exfoliative cytopathology, 2nd edn. Little Brown & Co., Boston
Naylor B (1963) The exfoliative cytology of diffuse malignant mesothelioma. J Pathol Bacteriol 86:293–298
Planteydt HT (1972) Asbestos and mesothelioma in the Netherlands. TNO-Nieuws 27:667–671
Spriggs AI, Boddington MM (1968) The cytology of effusions, 2nd edn. Heinemann, London
Liang-Che Tao (1979) The cytopathology of mesothelioma. Acta Cytol 23:209–213
Wang NS (1973) Electron microscopy in the diagnosis of pleural mesotheliomas. Cancer 32:1046–1054
Waridel D, Lanitis G (1976) Mesotheliome localisé du péritoine révelé par une masse pariétale. Schweiz Med Wochenschr 105:1026–1030
Whithaker D (1977) Cell aggregates in malignant mesothelioma. Acta Cytol 21:236–239
Whithaker D, Shilkin KB (1978) The cytology of malignant mesothelioma in western Australia. Acta Cytol 22:67–71
WHO (1977) Cytology of non-gynecological sites. International histological classification of tumours. World Health Organization, Geneva
Winslow DJ, Taylor HB (1960) Malignant peritoneal mesotheliomas. Cancer 13:127–137
Zajicek J (1974) Aspiration biopsy cytology. I Cytology of supradiaphragmatic organs. S Karger, Basel
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Boon, M.E., Posthuma, H.S., Ruiter, D.J. et al. Secreting peritoneal mesothelioma. Virchows Arch. A Path. Anat. and Histol. 392, 33–44 (1981). https://doi.org/10.1007/BF00430546
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DOI: https://doi.org/10.1007/BF00430546