Intraabdominal Desmoplastic Small Round Cell Tumour of the Peritoneum
Mačák J., Mukenšnábl P.1, Kawano N.2, Bobot L.3, Dušková M., Vácha P.4
Ústav patologické anatomie Lékařské fakulty Univerzity Palackého a Fakultní nemocnice a Laboratoř imunohistologických a speciálních metod, Olomouc1Šiklův patologicko-anatomický ústav LF UK, Plzeň2Division of Anatomic and Surgical Pathology, Hospital of Yokohama City University,Yokohama, Japan3Oddělení patologie nemocnice, Nový Jičín4Oddělení patologie nemocnice, Šumperk |
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Summary:
The authors described three cases of intraabdominal desmoplastic small round cell tumour of the
peritoneum (IDSRT). In one case the patient was a woman, and in the other two men. The age
ranged from 20–29 years. Common of all the cases was a rapid onset of clinical symptoms during
the period of twelve to eighteen months. In one case, a 22-year-old woman presented with a symptomless
course of disease documented by medical examination one month ago. Intensive chemotherapy
was applied but two patients died of generalisation. The 22-year-old woman is alive but
with clinical evidence of generalisation in the abdominal cavity. The „classical“ type of IDSRT
was found in all the cases. Sharply demarcated groups of tumour cells of different size were
surrounded by dense fibrous stroma. In some regions desmoplastic areas prevailed. In one case
the tumour consisted of round and oval cells resembling a lymphoma. In the other two cases, the
slightly elongated cells were present. Immunohistologically, the small round cells were positive
for cytokeratins with antibody AE1-AE3. Membrane and dot-like paranuclear positivity were
found. In 2 cases the reaction to desmin was seen in a dot-like paranuclear distribution, whereas
the reaction to smooth muscle actin (MSA) was negative. In all the cases positivity to vimentin
and neuron specific enolase (NSE) were apparent. Negative reactions were found for WT-1 antibody
in all three cases. In one of the cases the RT PCR reaction for chimeric gene EWS/WT1 was
performed, and found to be negative. Many different tumour types, such as lymphoma, Ewing
sarcoma/PNET, neuroblastoma, alveolar rhabdomyosarcoma, malignant mesothelioma must be
excluded. Cytogenetic examination should be performed on tumours with a „non-typical“ histological
pattern and uncommon inmmunohistological examinations.
Key words:
intraabdominal desmoplastic small round cell tumour of the peritoneum – immunohistological
findings – electron microscopic findings
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