马腹膜和胸膜的两期恶性间皮瘤

Reiner Ulrich, Maja Eydner, Anne Grün, Julia Haydn, Wolfgang Baumgärtner
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摘要

本文报告了一例13岁冰岛小马腹膜和胸膜腔双期恶性间皮瘤的宏观、组织学、免疫组织学和超微结构特征,临床表现为复发性腹水。采用抗细胞角蛋白(CK)和波形蛋白的多种单克隆抗体进行免疫组织学检查。超微结构检查包括定量评价微绒毛的长径比。尸检发现有严重的腹水和胸水。腹膜和胸膜的浆膜表面表现为界限不清,多灶到合并的层状肿块和小结节。组织学显示双形态肿块,由梭形细胞和微囊上皮样区组成。经体腔和局部浸润性生长模式以及淋巴结转移被注意到。免疫组织学显示强表达CK。虽然CK5/6和CK20分别低表达和中等表达,但缺乏CK7和ck10抗原。超微结构上,上皮样间皮瘤细胞显示长微绒毛、细胞质张力丝和桥粒。定量评价10个最长微绒毛的长径比显示平均值约为16.2。总之,本报告描述了一例恶性双期间皮瘤,其CK20表达不典型,但具有特征性的超微结构形态,包括长微绒毛。
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A biphasic malignant mesothelioma of the peritoneum and pleura in a horse.

This report describes the macroscopic, histologic, immunohistologic and ultrastructural characteristics ofa biphasic malignant mesothelioma in the peritoneal and pleural cavity of a 13-year-old Icelandic pony mare, which exhibited recurrent ascites clinically. Immunohistology was performed employing multiple monoclonal antibodies against cytokeratins (CK) and vimentin. The ultrastructural examination included the quantitative evaluation of the length to diameter ratio of the microvilli. Post mortem examination revealed a severe ascites and hydrothorax. The serosal surfaces of the peritoneum and pleura displayed poorly-demarcated, multifocal to coalescing laminar masses and small nodules. Histology revealed a bimorphic mass consisting of spindle-shaped cells and microcystic epithelioid areas. A transcoelomic and local invasive growth pattern as well as lymph node metastases were noticed. Immunohistology revealed a strong expression of CK. Though a low and moderate expression of CK5/6 and CK20 was present, respectively, CK7 and CK10-antigens were lacking. Ultrastructurally, the epithelioid mesothelioma cells displayed long microvilli, cytoplasmic tonofilaments, and desmosomes. Quantitative evaluation of the length to diameter ratio of the 10 longest microvilli revealed a mean value of approximately 16.2. Summarized, this report described the case of a malignant biphasic mesothelioma with an atypical CK20 expression but a characteristic ultrastructural morphology including long microvilli.

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