Well-differentiated papillary mesothelioma with invasive foci

Andrew Churg, Timothy Allen, Alain C. Borczuk, Philip T. Cagle, Francoise Galateau-Sallé, Harry Hwang, Bruno Murer, Vundavalli V. Murty, Nelson Ordonez, Henry D. Tazelaar, Mark Wick

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Well-differentiated papillary mesotheliomas (WDPMs) are usually encountered as incidental findings in the peritoneal cavity in women. Most WDPMs are benign, and the histologic features that indicate a more aggressive course are controversial. We report 20 cases of WDPM, which contained invasive foci. Thirteen cases arose in the peritoneal cavity, 1 in a hernia sac, 3 in the pleural cavity, and 3 in hydroceles. The female:male ratio was 16:4, and age range was 7 to 74 years. Tumor was multifocal in 15 cases. Some tumors showed back-to-back papillae, a pattern mimicking invasion but discernible on pan-keratin stain as compressive crowding. True invasive patterns ranged from simple bland-appearing glands invading the stalks of the papillae to solid foci of invasive tumor of higher cytologic grade than the original WDPM. All 5 tested cases were negative for p16 deletion by fluorescence in situ hybridization, but 2/3 had abnormal karyotypes. Recurrences were seen in 8 patients, and in 4 multiple recurrences were documented. Of 16 patients with follow-up, 14 are alive from periods of 6 months to 6 years (average 3.5 y), and 2 have known recurrent disease. One patient died of disseminated tumor at 8 years but without histologic confirmation of the nature of the tumor. We conclude that WDPM with invasive foci in the papillae appear to be prone to multifocality and recurrence, but that they rarely give rise to life-threatening disease. We suggest that these lesions be called WDPM with invasive foci to alert clinicians to the possibility of recurrence.

Original languageEnglish (US)
Pages (from-to)990-998
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume38
Issue number7
DOIs
StatePublished - 2014

Fingerprint

Mesothelioma
Recurrence
Peritoneal Cavity
Neoplasms
Abnormal Karyotype
Pleural Cavity
Incidental Findings
Hernia
Keratins
Fluorescence In Situ Hybridization
Coloring Agents

Keywords

  • malignant mesothelioma
  • p16 deletion
  • well-differentiated papillary mesothelioma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Churg, A., Allen, T., Borczuk, A. C., Cagle, P. T., Galateau-Sallé, F., Hwang, H., ... Wick, M. (2014). Well-differentiated papillary mesothelioma with invasive foci. American Journal of Surgical Pathology, 38(7), 990-998. https://doi.org/10.1097/PAS.0000000000000200

Well-differentiated papillary mesothelioma with invasive foci. / Churg, Andrew; Allen, Timothy; Borczuk, Alain C.; Cagle, Philip T.; Galateau-Sallé, Francoise; Hwang, Harry; Murer, Bruno; Murty, Vundavalli V.; Ordonez, Nelson; Tazelaar, Henry D.; Wick, Mark.

In: American Journal of Surgical Pathology, Vol. 38, No. 7, 2014, p. 990-998.

Research output: Contribution to journalArticle

Churg, A, Allen, T, Borczuk, AC, Cagle, PT, Galateau-Sallé, F, Hwang, H, Murer, B, Murty, VV, Ordonez, N, Tazelaar, HD & Wick, M 2014, 'Well-differentiated papillary mesothelioma with invasive foci', American Journal of Surgical Pathology, vol. 38, no. 7, pp. 990-998. https://doi.org/10.1097/PAS.0000000000000200
Churg A, Allen T, Borczuk AC, Cagle PT, Galateau-Sallé F, Hwang H et al. Well-differentiated papillary mesothelioma with invasive foci. American Journal of Surgical Pathology. 2014;38(7):990-998. https://doi.org/10.1097/PAS.0000000000000200
Churg, Andrew ; Allen, Timothy ; Borczuk, Alain C. ; Cagle, Philip T. ; Galateau-Sallé, Francoise ; Hwang, Harry ; Murer, Bruno ; Murty, Vundavalli V. ; Ordonez, Nelson ; Tazelaar, Henry D. ; Wick, Mark. / Well-differentiated papillary mesothelioma with invasive foci. In: American Journal of Surgical Pathology. 2014 ; Vol. 38, No. 7. pp. 990-998.
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