[1837] Sarcomatoid Peritoneal Mesothelioma: Clinicopathologic Correlation of 13 Cases

EN Pavlisko, VL Roggli. Duke University Medical Center, Durham, NC

Background: Peritoneal mesothelioma is rare and the sarcomatoid variant is more infrequent. Several case series have described the morphologic features of sarcomatoid peritoneal mesothelioma (SPe); however, the clinicocopathologic features are not well characterized.
Design: We reviewed our database of 2859 mesothelioma cases, of which 2524 (88%) were pleural and 335 (12%) were peritoneal. Of the peritoneal mesotheliomas, 252 (75%) were epithelioid, 70 (21%) were biphasic, and 13 (4%) were sarcomatoid variant.

Table 1: Demographics, Pathologic Findings, and Fiber Analysis
CaseAgeSexOccupation/ExposureParietal Pleural PlaquesAsbestosisTumor TypeAsbestos Content
170MJohns-Manville, many yrs.YYDSPeND
274MShipyard electrician, 16 yrs; Power plant worker, 21 yrs.YNDSPe LHCND
366MJohns-Manville, 39 yrs.YYDSPeND
470MMerchant marine seaman, 23 yrs.NDNDSPeND
565FHHC; Husband, shipyard workerNNSPeElevated
669MShipyard insulator, 49 yrs.YNDSPeND
859FHHC; Husband, construction worker, 42 yrs.NDNDSPeWNL
959MConstruction, 31 yrs.NDYSPeND
1049FHHC; Husband, power plantNDNDSPe HWNL
1372MElectrician, 24 yrsNNDSPeND
HHC, household contact; SPe, sarcomatoid peritoneal mesothelioma; DSPe, desmoplastic SPe; LHC, lymphohistiocytic; H, heterologous elements; ND, no data; WNL, within normal limits

Conclusions: To our knowledge, this is the first large series reporting the clinicopathologic features of SPe. The average age at diagnosis was 65.5 years and there was a male predominance (M:F = 3:1). All cases stained positive for cytokeratins, and two contained heterologous elements. Seven cases had objective markers of asbestos exposure (plaques, asbestosis, and/or elevated lung asbestos content), and two additional cases (4, 13) had occupations that are strongly associated with mesothelioma. Two cases with alleged household contact exposures (8, 10) could not be confirmed by lung fiber analysis. SPe is a rare variant of mesothelioma that is frequently related to asbestos exposure (9/13 cases).
Category: Pulmonary

Monday, March 22, 2010 2:15 PM

Platform Session: Section E, Monday Afternoon


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