Well-differentiated papillary mesothelial tumour: Difference between revisions

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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 mesothelial tumour. [[H&E stain]].
| Synonyms  = well-differentiated papillary mesothelioma (obsolete term), benign papillary mesothelioma (obsolete term)
| 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]] especially ''papillary mesothelioma in situ''
| Stains    =
| IHC        = calretinin +ve, CK5/6 +ve, BAP1 retained (normal)
| 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 mesothelial tumour''', abbreviated '''WDPMT''', is a rare benign mesothelial tumour.<ref name=pmid35440764>{{cite journal |authors=Churg A, Galateau-Salle F |title=Well differentiated papillary mesothelial tumor: a new name and new problems |journal=Mod Pathol |volume=35 |issue=10 |pages=1327–1333 |date=October 2022 |pmid=35440764 |doi=10.1038/s41379-022-01082-y |url=}}</ref>
 
It was previously known as ''well-differentiated papillary mesothelioma'', abbreviated ''WDPM''.<ref name=pmid35440764/><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 was also known as ''benign papillary mesothelioma''. This entity 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]] - especially [[papillary mesothelioma in situ]].
**''Papillary mesothelioma in situ'' is morphologically identical.<ref name=pmid35440764/>
 
===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.
*[[BAP1]] retained (normal).<ref name=pmid35440764/>
*MTAP retained (normal).
**May not be sensitive.{{fact}}
*[[Claudin-4]] -ve.{{fact}}
 
==Sign out==
<pre>
A. Submitted as "Peritoneal Deposit", Excision:
- Well-differentiated papillary mesothelial tumour, see comment.
- NEGATIVE for malignancy.
 
Comment:
Well-differentiated papillary mesothelial tumour is a benign tumour.
 
The tumour has retained (normal) BAP1 and retained MTAP staining.
Claudin-4 and NF2F are NEGATIVE.
</pre>
 
==See also==
*[[Peritoneum]].
*[[Malignant mesothelioma]].
*[[Mesothelioma]].
 
==References==
{{Reflist|2}}


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