Difference between revisions of "Peritoneum"
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=Benign= | =Benign= | ||
==Well-differentiated papillary mesothelioma== | |||
:Should '''not''' be confused with ''[[malignant mesothelioma]]'' or ''[[benign multicystic mesothelioma]]''. | |||
*[[AKA]] ''benign papillary mesothelioma''. | |||
===General=== | |||
*Benign. | |||
*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> | |||
===Gross=== | |||
Features: | |||
*Multiple peritoneal nodules. | |||
*Ascites. | |||
DDx:<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. | |||
Image: | |||
*[http://www.webpathology.com/image.asp?n=10&Case=86 Benign papillary mesothelioma (webpathology.com)]. | |||
==Benign multicystic mesothelioma== | ==Benign multicystic mesothelioma== | ||
:Should '''not''' be confused with ''[[malignant mesothelioma]]''. | :Should '''not''' be confused with ''[[malignant mesothelioma]]''. | ||
Revision as of 18:48, 28 April 2012
The peritoneum is a much neglected area, with relatively little pathology. It includes the omentum which is dealt with in the omentum article.
Benign
Well-differentiated papillary mesothelioma
- Should not be confused with malignant mesothelioma or benign multicystic mesothelioma.
- AKA benign papillary mesothelioma.
General
- Benign.
- Classically women of reproductive age.[1]
Gross
Features:
- Multiple peritoneal nodules.
- Ascites.
DDx:[1]
- Tuberculosis.
- Carcinomatosis.
- Primary peritoneal serous carcinoma.
Microscopic
Features:
- Papillary structures with:
- Thick fibrous cores.
- Simple cuboidal epithelium.
- Small nucleoli.
Note:
- Lack cytologic atypia.
Image:
Benign multicystic mesothelioma
- Should not be confused with malignant mesothelioma.
- AKA peritoneal inclusion cyst.[2]
- AKA inflammatory cyst of the peritoneum.
- AKA mesothelial inclusion cyst. (???)
General
- Usually conservative management.
- Serum CA-125 usually low.
- May occur in men.[3]
Microscopic
- Thin-walled, irregular-shaped, cysts - unicystic or multicystic.
- Mesothelial lining.
- Eosinophilic fluid.
Image:
Malignant
Primary peritoneal serous carcinoma
General
- Very rare.
- Reported in men.[5]
Microscopic
Features:
- Like serous carcinoma elsewhere - see ovarian serous carcinoma.
- To exclude ovarian serous carcinoma all of the following criteria must be met:[6]
- Histology of the tumour = serous carcinoma.
- Bulk of the tumour involves the peritoneum.
- Ovarian substance tumour extent less than 5 x 5 mm in plane of section.
- Previous ovarian serous carcinoma is excluded.
- Old oopherectomies reviewed if possible.
DDx:
- Ovarian serous carcinoma.
- Other serous carcinomas - see serous carcinoma.
- Malignant mesothelioma.
IHC
- Like serous carcinoma elsewhere - see ovarian serous carcinoma.
See also
References
- ↑ 1.0 1.1 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.
- ↑ 2.0 2.1 Vallerie, AM.; Lerner, JP.; Wright, JD.; Baxi, LV. (May 2009). "Peritoneal inclusion cysts: a review.". Obstet Gynecol Surv 64 (5): 321-34. doi:10.1097/OGX.0b013e31819f93d4. PMID 19386139.
- ↑ Cavallaro, A.; Murazio, M.; Modugno, P.; Vona, A.; Revelli, L.; Potenza, AE.; Colli, R.. "Benign multicystic mesothelioma of the peritoneum: a case report.". Chir Ital 54 (4): 569-72. PMID 12239771.
- ↑ Levy, AD.; Arnáiz, J.; Shaw, JC.; Sobin, LH.. "From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation.". Radiographics 28 (2): 583-607; quiz 621-2. doi:10.1148/rg.282075175. PMID 18349460.
- ↑ Shmueli, E.; Leider-Trejo, L.; Schwartz, I.; Aderka, D.; Inbar, M. (Apr 2001). "Primary papillary serous carcinoma of the peritoneum in a man.". Ann Oncol 12 (4): 563-7. PMID 11398893.
- ↑ Roh, SY.; Hong, SH.; Ko, YH.; Kim, TH.; Lee, MA.; Shim, BY.; Byun, JH.; Woo, IS. et al. (Jun 2007). "Clinical characteristics of primary peritoneal carcinoma.". Cancer Res Treat 39 (2): 65-8. doi:10.4143/crt.2007.39.2.65. PMC 273931. PMID 19746214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC273931/.