Pleura
Mesothelial tumors
Benign multicystic mesothelioma


Topic Completed: 1 August 2013

Revised: 1 March 2019

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PubMed Search: Benign multicystic mesothelioma pleural
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Cite this page: Avadhani V. Benign multicystic mesothelioma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/pleurab9multicysticmeso.html. Accessed March 23rd, 2019.
Definition / general
Terminology
  • Now termed multicystic mesothelial tumor of borderline biologic potential (MMTBBP)
Epidemiology
  • Very rare in pleura - most cases reported have been from peritoneum
  • Usually reported in women of reproductive age (mean age 37 years)
Sites
  • Peritoneum, pleura, pericardium
Clinical features
  • Pleura: localized mass found on imaging studies
  • Abdomen: chronic or intermittent abdominal pain (most common), abdominal distension, urinary hesitancy
Radiology description
Radiology images

Images hosted on other servers:

Peritoneal tumors:

Sagittal endovaginal sonogram (Figure 17b)

IV contrast enhanced CT scans (Figures 18a & b)

Case reports
Treatment
  • Surgical resection
  • Also sclerosants, hormonal therapy, radiotherapy, chemotherapy
  • Peritoneal lesions may recur
  • Usually patients with recurrent disease have long survival as lesion grows slowly
Gross description
  • Well circumscribed mass of multiple thin walled cysts with serous fluid, easily dissected from surrounding tissue
Gross images

Images hosted on other servers:

Peritoneal masses:

Multicystic mass

Multiple thin walled, irregular shaped cysts

Microscopic (histologic) description
  • Cystic spaces lined by single layer of bland cuboidal mesothelial cells, some with hobnailing
  • Cysts are filled with eosinophilic serous fluid
  • Stroma is hypocellular and collagenized
  • No nucleoli or mitotic activity
Microscopic (histologic) images

Images hosted on other servers:

Peritoneal tumors:

Multiple thin walled, irregular cysts (Left: Figure 16a)

Loose fibrous stroma between cysts
(Figure 16b)

Mesothelial cells line cysts

Cytology description
  • Fluid cytology and cell blocks show benign appearing mesothelial cells in flat sheets and small clusters, with low N/C ratio, rounded nuclei and indistinct nucleoli (Diagn Cytopathol 2010;38:192)
Positive stains
Negative stains
Electron microscopy description
Differential diagnosis
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