engleski

Malignant peritoneal mesothelioma-epitheloid type: a case report

Malignant peritoneal mesothelioma (MPM) is a rare aggressive tumor of the peritoneum, regarded as a universally fatal disease. Only 20-33% of all mesotheliomas arise from the peritoneum itself, while the pleura is the most common site of origin. Exposure to asbest can be documented in about 80% of the cases. Mesothelioma can arise both from visceral and parietal peritoneum. It is diagnosed in advanced stages in most cases, and is often takes considerable time to achieve the correct diagnosis. The most frequent initial symptoms are abdominal pain, abdominal swelling, anorexia, weight loss and ascites. The clinical, routine laboratory tests and radiologic presentation of mesothelioma is nonspecific. Mesotheliomas have three basic histologic forms: epitheloid , sarcomatoid and mixed. Case report: A 39 year-old male experienced a history of abdominal pain and severe weihght loss (30kg) last six months. On clinic examination no specific simptoms were found. On ultrasound and MSCT of abdomen ascites in abdomen were found. Laboratory findings were within normal reference values. Tumor markers were negative. Cytologic findings of ascites showed atipical and highly suspicious mesothelial cells. Imunocitochemistry were done and atipical cells expressed membranous positivity for Ber EP4 and partial positivity for trombomodulin and vimentin. Cytokeratins (CK19, CK20, CK7, CK18) and Ca 19-9 were in atipical cells negative. Laparotomy and tumor biopsy were performed. Final patologyc diagnoses was malignat peritoneal mesothelioma- epitheloid type. Conclusion: The role of cytology in diagnosis of malignant peritoneal mesothelioma is important and it can be made in approximaly 80% of cases if an adequate sample of the tumor cells can be obtained.

Cytology; malignant peritoneal mesothelioma; epitheloid type

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