PMC5457933_01
Intravenous contrast-enhanced CT scans show massive ascites, thickening of the anterior peritoneum (white arrow in Panel A), and a nodule in the anterior peritoneum (white arrow in Panel B). The mesentery is shortened due to malignant infiltration (white arrow in Panel C).
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We performed enhanced abdominal computed tomography (CT) to investigate the cause of abdominal distension, which revealed massive ascites, thickening of the anterior peritoneum, and shortening of the mesentery (Fig. 1).
The macroscopic findings at autopsy; the digestive tract and the other abdominal organs have become a single mass.
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Severe adhesion of the digestive tract was observed, which formed a cluster with the abdominal organs (Fig. 2).
Photomicrographs of Hematoxylin and Eosin (H&E) staining sections (left: H&E stainingx40, right: H&E stainingx400). Panel A shows the tubulopapillary pattern and Panel B shows the sarcomatous pattern.
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A histological examination of the Hematoxylin and Eosin (H&E) staining sections revealed neoplastic cells with a tubulopapillary appearance (Fig. 3A), as well as tightly packed spindle cells (Fig. 3B), which represented epithelioid and sarcomatous tumor components, respectively.
Photomicrographs of immunohistochemical staining for HBME-1 (Panel A: x100) and calretinin (Panel B: x100). Both markers are positive.
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The tumor cells were negative for carcinoembryonic antigen (a marker of adenocarcinoma), but were positive for HBME-1 (Fig. 4A), calretinin (Fig. 4B), cytokeratin, CAM 5.2, and cytokeratin 5/6 (markers of mesothelioma) on immunohistochemical staining.