Peritoneal mesothelial hyperplasia associated with gynaecological disease

TY - JOUR

T1 - Peritoneal mesothelial hyperplasia associated with gynaecological disease

T2 - a potential diagnostic pitfall that is commonly associated with endometriosis

A1 - Oparka,Richard

A1 - McCluggage,W. Glenn

A1 - Herrington,C. Simon

AU - Oparka,Richard

AU - McCluggage,W. Glenn

AU - Herrington,C. Simon

PY - 2011/4

Y1 - 2011/4

N2 - <p>Aims To describe the clinicopathological features of florid peritoneal mesothelial hyperplasia associated with gynaecological disease.</p><p>Methods Review of a series of 44 cases where there was significant peritoneal mesothelial proliferation, usually on the surface of the ovary, which resulted in diagnostic problems, often including a consideration of malignancy.</p><p>Results Florid mesothelial proliferation was associated with a variety of benign and malignant lesions, most commonly endometriosis. The most characteristic morphological appearance was that of small bland tubules and nests and cords of cells often embedded in fibrous tissue, sometimes with a linear arrangement. In a minority of cases, there were closely packed small glands and papillae resulting in mimicry of a serous proliferation; psammoma bodies were present in one such case. In several cases, the groups of mesothelial cells either exhibited true lymphovascular invasion or were surrounded by spaces closely simulating lymphovascular invasion. Although most cases were appreciated to represent a reactive mesothelial proliferation, several were referred with a presumed or possible diagnosis of mesothelioma, low-grade serous carcinoma, adenocarcinoma, adenomatoid tumour or Sertoli cell tumour. Positive staining with calretinin and negative staining with Ber-EP4 often helped to identify the cells as mesothelial rather than epithelial.</p><p>Conclusions Florid peritoneal mesothelial hyperplasia can occur in association with a variety of gynaecological disorders. Recognition of this phenomenon and appreciation that it can produce worrisome histological patterns, particularly when associated with endometriosis, is key to reaching the correct diagnosis.</p>

AB - <p>Aims To describe the clinicopathological features of florid peritoneal mesothelial hyperplasia associated with gynaecological disease.</p><p>Methods Review of a series of 44 cases where there was significant peritoneal mesothelial proliferation, usually on the surface of the ovary, which resulted in diagnostic problems, often including a consideration of malignancy.</p><p>Results Florid mesothelial proliferation was associated with a variety of benign and malignant lesions, most commonly endometriosis. The most characteristic morphological appearance was that of small bland tubules and nests and cords of cells often embedded in fibrous tissue, sometimes with a linear arrangement. In a minority of cases, there were closely packed small glands and papillae resulting in mimicry of a serous proliferation; psammoma bodies were present in one such case. In several cases, the groups of mesothelial cells either exhibited true lymphovascular invasion or were surrounded by spaces closely simulating lymphovascular invasion. Although most cases were appreciated to represent a reactive mesothelial proliferation, several were referred with a presumed or possible diagnosis of mesothelioma, low-grade serous carcinoma, adenocarcinoma, adenomatoid tumour or Sertoli cell tumour. Positive staining with calretinin and negative staining with Ber-EP4 often helped to identify the cells as mesothelial rather than epithelial.</p><p>Conclusions Florid peritoneal mesothelial hyperplasia can occur in association with a variety of gynaecological disorders. Recognition of this phenomenon and appreciation that it can produce worrisome histological patterns, particularly when associated with endometriosis, is key to reaching the correct diagnosis.</p>

KW - SEROUS PAPILLARY CARCINOMA

KW - IMMUNOHISTOCHEMICAL MARKERS

KW - EPITHELIOID MESOTHELIOMA

KW - PLEURAL MESOTHELIOMA

KW - PSAMMOMA BODIES

KW - OVARIAN-TUMORS

KW - ADENOCARCINOMA

KW - BER-EP4

KW - DISTINCTION

KW - CALRETININ

U2 - 10.1136/jcp.2010.086074

DO - 10.1136/jcp.2010.086074

M1 - Article

JO - Journal of Clinical Pathology

JF - Journal of Clinical Pathology

SN - 0021-9746

IS - 4

VL - 64

SP - 313

EP - 318

ER -