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Peritoneal malignant mesothelioma: Slippery like an eel to diagnose on cytology-case series of 3 cases.
Gupta, Navita; Soni, Ankita; Mahajan, Ramit; Selhi, Pavneet; Tyagi, Ruchita; Garg, Bhavna; Kaur, Harpreet.
Afiliación
  • Gupta N; Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.
  • Soni A; Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.
  • Mahajan R; Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.
  • Selhi P; Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.
  • Tyagi R; Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India. Electronic address: ruchitatyagi@gmail.com.
  • Garg B; Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.
  • Kaur H; Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.
J Am Soc Cytopathol ; 11(1): 40-45, 2022.
Article en En | MEDLINE | ID: mdl-34602383
INTRODUCTION: Peritoneal malignant mesothelioma is an extremely rare tumor and is a difficult diagnosis to be made on cytology alone. We report 3 cases where the cytologic features were misdiagnosed as carcinoma/lymphoma but histopathology and immunohistochemistry (IHC) established the diagnosis of malignant mesothelioma. CLINICAL DETAILS: Case 1 was a 60-year-old man with multiloculated ascites and omental caking. Peritoneal fluid was reported as malignant on cytology but was misclassified as adenocarcinoma. Case 2, a 45-year-old man with ascites and peritoneal nodularity, radiologically mimicking peritoneal carcinomatosis, was also reported positive for malignancy on ascitic fluid cytology. Fine-needle aspiration (FNAC) from omental fat revealed signet ring cells, thus misleading to cytologic diagnosis of adenocarcinoma. Case 3 was a 63-year-old man with perisplenic mass with extensive omental caking and peritoneal nodularity that was also suspected to be peritoneal carcinomatosis on radiology. FNAC smears from perisplenic mass showed sheets of plasmacytoid cells. On cytology, the differential diagnoses offered were neuroendocrine tumor or non-Hodgkin lymphoma. The diagnosis of malignant mesothelioma was established only after IHC on histopathologic sections in all these cases. None of our patients had history of prior asbestos exposure. CONCLUSION: In such clinical scenarios, with radiology suggesting peritoneal carcinomatosis, the cytologic features need corroboration by IHC/fluorescence in situ hybridization on cell block or biopsy to correctly identify malignant mesothelioma and differentiate it from metastatic carcinomatous deposits and benign mesothelial proliferation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Peritoneales / Mesotelioma Maligno Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans / Male / Middle aged Idioma: En Revista: J Am Soc Cytopathol Año: 2022 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Peritoneales / Mesotelioma Maligno Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans / Male / Middle aged Idioma: En Revista: J Am Soc Cytopathol Año: 2022 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos