Abstract
A 34-year-old female, with a history of continued asbestos exposure, presented with a papillary peritoneal mesothelioma with a diffuse, prominent clear foamy cell change, with microvacuolation in its papillary lining, that expressed cytokeratins 7, 5/6 and calretinin as well as nuclear WT-1 and apical membrane staining for thrombomodulin, podoplanin D2-40 and HBME-1. In contrast, lining cells were CD68 negative. Foamy cell change has been reported in isolated cases as solid cords but not as a diffuse change in the mesothelial papillary lining. This phenomenon prompts differential diagnoses with abdominal and renal papillary clear cell tumours, which were discarded after a characteristic mesothelial immunophenotype was demonstrated.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4679576081031834.
Highlights
Malignant mesothelioma of the peritoneal cavity accounts for only 10-20% of all mesotheliomas and usually involves elderly or middle age males, often with a previous history of asbestos exposure [1]
We report here such a case in a patient exposed to asbestos, where a diffuse, prominent clear foamy cell change prompted various differential diagnoses with abdominal and renal papillary clear cell tumours, which were discarded after a characteristic mesothelial immunophenotype was demonstrated
A continuous exposure of more than 30 years to asbestos fibers present in the roof plates of the house was found. This is in agreement with previous published studies that show a latency period after asbestos exposure and eventual mesothelioma development ranging from 4–40 years, cases with a shorter period have been reported [10,11]
Summary
Malignant mesothelioma of the peritoneal cavity accounts for only 10-20% of all mesotheliomas and usually involves elderly or middle age males, often with a previous history of asbestos exposure [1]. The occurrence of this tumour in young women is rare [2] and related with lesser frequency to asbestos exposure [3,4]. Foamy tumour cells forming solid sheets, have been described in three cases of malignant mesothelioma of the peritoneum [1,5], two in the pleura and one of the tunica vaginalis testis [6-8]. Case presentation A 34-year-old non-smoking female, with a history of 30 years of continued exposure to roofing and wall
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