PMC4899850_01
28-year-old female with malignant peritoneal mesothelioma. Axial, contrast-enhanced CT section of the abdomen in the arterial phase shows a large, heterogenous, peritoneal lesion displacing the bowel loops centrally.
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CT of the abdomen showed large, nonenhancing, multinodular lesions of attenuation 27-35 HU distributed around the periphery of the abdominal cavity, with a centrally displaced small bowel and mesentery (Fig. 1).
28-year-old female with malignant peritoneal mesothelioma. Axial, contrast-enhanced CT section of the abdomen in the arterial phase shows a heterogenously enhancing lesion predominantly cystic components in the left adnexa (asterisk).
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Another cystic lesion was seen in the left adnexa (Fig. 2).
28-year-old female with malignant peritoneal mesothelioma. Coronal, contrast-enhanced CT section of the abdomen in the arterial phase shows an ill-defined, heterogenously enhancing lesion with cystic and solid components in the peritoneal cavity with a cystic lesion in the left adnexa. Ascites is also seen.
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Ascites was also seen around the liver (Fig. 3).
28-year-old female with malignant peritoneal mesothelioma. At laparotomy, the whole abdomen was seen to be covered with massive nodular masses that seemed to arise from the omentum. The whole mass weighed 2Kg, approximately.
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Intraoperatively, multiple nodular lesions were seen infliltrating the omentum with centrally encased bowel loops (Fig. 4).
28-year-old female with malignant peritoneal mesothelioma. Hematoxylin and eosin staining of the frozen section shows a highly cellular tumor consisting of spindle-out cells arranged in interlacing bundles and sheets. The cells have hyperchromatic nuclei with mild anisocytosis.
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The cells had hyperchromatic nuclei with mild anisocytosis (Fig. 5).
28-year-old female with malignant peritoneal mesothelioma. A: Immunohistochemical staining for CD 10 was positive, suggesting the possibility of sarcomatous or mesothelial origin. B: Immunohistochemical staining for WT 1 was positive, confirming the diagnosis of mesothelioma.
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Immunohistochemical analysis was positive for CD 10, WT1, and C-Kit, and negative for ER and PR, confiming the histological diagnosis of malignant peritoneal mesothelioma (Figs. 6A and 6B).