12th Ljudevit Jurak International Symposium on
Comparative Pathology
Zagreb
June 1-2, 2001
 

POSTER PRESENTATION
LOCALIZED PERITONEAL MESOTHELIOMA - A CASE REPORT
F. Kneževiæ, V. Šeparoviæ, M. Šèukanec, D. Vrdoljak, V. Orešiæ, R. Šeparoviæ
University Hospital for Tumors: Zagreb, Croatia
Authors report of a 71-yeas-old man admitted for manifestations of subileus. US and CT revealed an indefinable, extensive and expansive process in the abdomen. Laparotomy showed a tumor of about 15 cm in diameter attached to the mesenteric ileum and with its upper portion coalesed to a jejunum loop. In order to remove the tumor, resection of the jejunum, ileum and ascending colon was performed using termo-terminal anastomosis and ileotransversal anastomosis, respectively. Macroscopic examination demonstrated a lymphoma-like multinodular lesion of 15 cm in diameter, gray-white at cross section, homogenous and soft situated on the mesenteric root. Small intestine loops, cecum, apendix and ascending colon were macroscopically normal. Moreover, extensive histologic and imunohistochemical examination excluded mucinous adenocarcinoma (cytokeratin -, EMA -), non Hodgkin lymphoma (LCA -, CD20 -, CD3 -, CD68 -), extra-adrenal paraganglioma (NSE -, chromogranin -, sinatophysin -, factor  no perivascular rosettes), yolk-sac tumor (alpha-fetoprotein -), and desmoplastic small round cell tumor (cytokeratin -, EMA -, vimentin +, desmin -).Ultrastructural examination of the described tumor showed a cell arrangment with wide intercellular spaces and desmosomes at the contact area of adjacent cells. A considerable number of cells were covered by microvilli. Moreover, many cells contained a  well-developed Golgi apparatus with extended vesicles filled with fluffy material also found in intercellular spaces. In addition, cytoplasm of many cells accommodated lamellar inclusion bodies or myelosoma. Based on the above ultrastructural picture and positive anti-thrombomodulin markers the diagnosis of poorly differentiated peritoneal mesothelioma was made.

REFERENCES: 
Beutler E: Gaucher disease. N. Engl J. Med. 325:1354-1360, 1991
Schneider EL., Epstein CJ. Kaback MJ, et al: Severe pulmonary involvement in adult Gaucher‘s disease. Am J Med. 63:475-480, 1977
Lee RE. The pathology of Gaucher disease. Prog. Clin Biol Res 95:177-217, 1982
Amir G,Ron N:Pulmonary pathology in Gaucher’s disease.Hum.Pathol.1999,Jun,30(6):666-7 
Stewart AJ, Jones RD: Pseudo-Gaucher cells in myelodysplasia. J Clin Pathol 1999 52:917-8
Eto Y, Ida H: Clinical and molecular characteristics of Japanese Gaucher disease. Neurochem Res 1999 Feb; 24(2): 207-11.
Maclean K, Wilson MJ: Splenic abscess in a patient with type 3 Gaucher‘s disease receving enzyme replacement therapy. J Pediatr 1999 Feb; 134(2):245-7
Kerem E, Elstein D, Abrahamov A, et al: Pulmonary function abnormalities in type I Gaucher disease. Eur Respir J 9:340-345, 1996.

Poster Presentation