Difference between revisions of "Well-differentiated papillary mesothelioma"

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#redirect [[Peritoneum#Well-differentiated_papillary_mesothelioma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Well-differentiated_papillary_mesothelioma_--_intermed._mag.jpg
| Width      =
| Caption    = Well-differentiated papillary mesothelioma. [[H&E stain]].
| Synonyms  = benign papillary mesothelioma
| Micro      = papillary structures with thick fibrous cores and simple cuboidal epithelium, lacks cytologic atypia
| Subtypes  =
| LMDDx      = [[ovarian serous carcinoma]], [[serous borderline tumour of the ovary]], [[malignant mesothelioma]]
| Stains    =
| IHC        = calretinin +ve, CK5/6 +ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[pleura]], [[peritoneum]], tunica vaginalis ([[testis]])
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = typically indolent
| Other      =
| ClinDDx    = [[tuberculosis]], [[carcinoma|carcinomatosis]], [[primary peritoneal serous carcinoma]], others
| Tx        =
}}
'''Well-differentiated papillary mesothelioma''', abbreviated '''WDPM''', is a rare type of [[mesothelioma]] that typically has an indolent behaviour.<ref name=pmid11688466>{{Cite journal  | last1 = Butnor | first1 = KJ. | last2 = Sporn | first2 = TA. | last3 = Hammar | first3 = SP. | last4 = Roggli | first4 = VL. | title = Well-differentiated papillary mesothelioma. | journal = Am J Surg Pathol | volume = 25 | issue = 10 | pages = 1304-9 | month = Oct | year = 2001 | doi =  | PMID = 11688466 }}</ref>
 
It is also known as '''benign papillary mesothelioma'''. It should '''not''' be confused with ''[[malignant mesothelioma]]'' and ''[[benign multicystic mesothelioma]]''.
 
==General==
*Benign.
**Some say it is ''borderline''.<ref name=pmid2122588>{{Cite journal  | last1 = Bürrig | first1 = KF. | last2 = Pfitzer | first2 = P. | last3 = Hort | first3 = W. | title = Well-differentiated papillary mesothelioma of the peritoneum: a borderline mesothelioma. Report of two cases and review of literature. | journal = Virchows Arch A Pathol Anat Histopathol | volume = 417 | issue = 5 | pages = 443-7 | month =  | year = 1990 | doi =  | PMID = 2122588 }}</ref>
*Classically women of reproductive age.<ref name=pmid18716115>{{Cite journal  | last1 = Park | first1 = JY. | last2 = Kim | first2 = KW. | last3 = Kwon | first3 = HJ. | last4 = Park | first4 = MS. | last5 = Kwon | first5 = GY. | last6 = Jun | first6 = SY. | last7 = Yu | first7 = ES. | title = Peritoneal mesotheliomas: clinicopathologic features, CT findings, and differential diagnosis. | journal = AJR Am J Roentgenol | volume = 191 | issue = 3 | pages = 814-25 | month = Sep | year = 2008 | doi = 10.2214/AJR.07.3628 | PMID = 18716115 | URL = content/191/3/814.full.pdf}}</ref>
*Reported in tunica vaginalis of the [[testis]].<ref name=pmid1452778>{{Cite journal  | last1 = Chetty | first1 = R. | title = Well differentiated (benign) papillary mesothelioma of the tunica vaginalis. | journal = J Clin Pathol | volume = 45 | issue = 11 | pages = 1029-30 | month = Nov | year = 1992 | doi =  | PMID = 1452778 }}</ref>
*Associated with asbestos exposure.<ref name=pmid11688466/>
 
==Gross==
Typical features for peritoneum:
*Multiple peritoneal nodules.
*Ascites.
 
DDx (peritoneum):<ref name=pmid18716115/>
*[[Tuberculosis]].
*Carcinomatosis.
*[[Primary peritoneal serous carcinoma]].
 
==Microscopic==
Features:
*Papillary structures with:
**Thick fibrous cores.
**Simple cuboidal epithelium.
***Small nucleoli.
 
Note:
*Lack cytologic atypia.
 
DDx:<ref>{{Cite journal  | last1 = Truong | first1 = LD. | last2 = Maccato | first2 = ML. | last3 = Awalt | first3 = H. | last4 = Cagle | first4 = PT. | last5 = Schwartz | first5 = MR. | last6 = Kaplan | first6 = AL. | title = Serous surface carcinoma of the peritoneum: a clinicopathologic study of 22 cases. | journal = Hum Pathol | volume = 21 | issue = 1 | pages = 99-110 | month = Jan | year = 1990 | doi =  | PMID = 1688545 }}</ref>
*[[Ovarian serous carcinoma]].
*[[Serous borderline tumour of the ovary]].
*[[Malignant mesothelioma]].
 
===Images===
<gallery>
Image: Well-differentiated papillary mesothelioma -- low mag.jpg | WDPM - low mag.
Image: Well-differentiated papillary mesothelioma -- intermed. mag.jpg | WDPM - intermed. mag.
Image: Well-differentiated papillary mesothelioma -- high mag.jpg | WDPM - high mag.
Image: Well-differentiated papillary mesothelioma -- very high mag.jpg | WDPM - very high mag.
</gallery>
<gallery>
Image: Well-differentiated papillary mesothelioma - alt -- low mag.jpg | WDPM - low mag.
Image: Well-differentiated papillary mesothelioma - alt -- intermed. mag.jpg | WDPM - intermed. mag.
Image: Well-differentiated papillary mesothelioma - alt -- high mag.jpg | WDPM - high mag.
</gallery>
www:
*[http://www.webpathology.com/image.asp?n=10&Case=86 Benign papillary mesothelioma (webpathology.com)].
 
==IHC==
Features:<ref name=pmid22024662>{{Cite journal  | last1 = Malpica | first1 = A. | last2 = Sant'Ambrogio | first2 = S. | last3 = Deavers | first3 = MT. | last4 = Silva | first4 = EG. | title = Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases. | journal = Am J Surg Pathol | volume = 36 | issue = 1 | pages = 117-27 | month = Jan | year = 2012 | doi = 10.1097/PAS.0b013e3182354a79 | PMID = 22024662 }}</ref>
*Calretinin +ve.
*CK5/6 +ve.
 
==See also==
*[[Peritoneum]].
*[[Malignant mesothelioma]].
*[[Mesothelioma]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Peritoneum]]

Latest revision as of 06:05, 21 July 2016

Well-differentiated papillary mesothelioma
Diagnosis in short

Well-differentiated papillary mesothelioma. H&E stain.
Synonyms benign papillary mesothelioma
LM papillary structures with thick fibrous cores and simple cuboidal epithelium, lacks cytologic atypia
LM DDx ovarian serous carcinoma, serous borderline tumour of the ovary, malignant mesothelioma
IHC calretinin +ve, CK5/6 +ve
Site pleura, peritoneum, tunica vaginalis (testis)
Prevalence rare
Prognosis typically indolent
Clin. DDx tuberculosis, carcinomatosis, primary peritoneal serous carcinoma, others

Well-differentiated papillary mesothelioma, abbreviated WDPM, is a rare type of mesothelioma that typically has an indolent behaviour.[1]

It is also known as benign papillary mesothelioma. It should not be confused with malignant mesothelioma and benign multicystic mesothelioma.

General

  • Benign.
    • Some say it is borderline.[2]
  • Classically women of reproductive age.[3]
  • Reported in tunica vaginalis of the testis.[4]
  • Associated with asbestos exposure.[1]

Gross

Typical features for peritoneum:

  • Multiple peritoneal nodules.
  • Ascites.

DDx (peritoneum):[3]

Microscopic

Features:

  • Papillary structures with:
    • Thick fibrous cores.
    • Simple cuboidal epithelium.
      • Small nucleoli.

Note:

  • Lack cytologic atypia.

DDx:[5]

Images

  • WDPM - low mag.

  • WDPM - intermed. mag.

  • WDPM - high mag.

  • WDPM - very high mag.

  • WDPM - low mag.

  • WDPM - intermed. mag.

  • WDPM - high mag.

www:

IHC

Features:[6]

  • Calretinin +ve.
  • CK5/6 +ve.

See also

References

  1. ↑ 1.0 1.1 Butnor, KJ.; Sporn, TA.; Hammar, SP.; Roggli, VL. (Oct 2001). "Well-differentiated papillary mesothelioma.". Am J Surg Pathol 25 (10): 1304-9. PMID 11688466.
  2. ↑ Bürrig, KF.; Pfitzer, P.; Hort, W. (1990). "Well-differentiated papillary mesothelioma of the peritoneum: a borderline mesothelioma. Report of two cases and review of literature.". Virchows Arch A Pathol Anat Histopathol 417 (5): 443-7. PMID 2122588.
  3. ↑ 3.0 3.1 Park, JY.; Kim, KW.; Kwon, HJ.; Park, MS.; Kwon, GY.; Jun, SY.; Yu, ES. (Sep 2008). "Peritoneal mesotheliomas: clinicopathologic features, CT findings, and differential diagnosis.". AJR Am J Roentgenol 191 (3): 814-25. doi:10.2214/AJR.07.3628. PMID 18716115.
  4. ↑ Chetty, R. (Nov 1992). "Well differentiated (benign) papillary mesothelioma of the tunica vaginalis.". J Clin Pathol 45 (11): 1029-30. PMID 1452778.
  5. ↑ Truong, LD.; Maccato, ML.; Awalt, H.; Cagle, PT.; Schwartz, MR.; Kaplan, AL. (Jan 1990). "Serous surface carcinoma of the peritoneum: a clinicopathologic study of 22 cases.". Hum Pathol 21 (1): 99-110. PMID 1688545.
  6. ↑ Malpica, A.; Sant'Ambrogio, S.; Deavers, MT.; Silva, EG. (Jan 2012). "Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases.". Am J Surg Pathol 36 (1): 117-27. doi:10.1097/PAS.0b013e3182354a79. PMID 22024662.
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