Pleura
Mesothelial tumors
Mesothelioma - deciduoid variant


Topic Completed: 1 November 2013

Revised: 2 October 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Deciduoid mesothelioma

See Also: Mesothelioma

Vaidehi Avadhani, M.D.
Page views in 2019: 379
Page views in 2020 to date: 173
Cite this page: Avadhani V. Mesothelioma - deciduoid variant. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/pleuramesotheliomadeciduoid.html. Accessed April 9th, 2020.
Definition / general
  • Rare variant of epithelioid mesothelioma that resembles decidua or decidual type changes
Terminology
Epidemiology
  • Initial reports suggested occurrence in young women, without asbestos exposure, with highly aggressive behavior but recent reports indicate wide age range and not as aggressive as previously believed (Mod Pathol 2012;25:1481)
Sites
  • Pleura and peritoneum are most common sites; tumors of pericardium and spermatic cord have also been reported
Radiology images

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Lobulated mass in upper region of left hemithorax

Case reports
Microscopic (histologic) description
  • Sheet-like proliferation of large, rounded, ovoid or polygonal cohesive cells with well defined cell borders and pale to bright, abundant eosinophilic cytoplasm resembling decidua with marked vacuolation, imparting a focal clear cell appearance
  • Nuclei are large, round / oval, pleomorphic with vesicular chromatin, may be binucleated or multinucleated, have central prominent nucleoli (Am J Surg Pathol 2000;24:285)
  • Occasional binucleated tumor cells
  • Fibrotic stroma with extensive coagulative tumor cell necrosis
  • Frequent mitotic figures
  • Atypical mesothelial cells present on pleura of adherent lung
  • May have focal rhabdoid areas
  • No squamous or glandular differentiation
Microscopic (histologic) images

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Involving and lining the adipose tissue

Cytology description
  • Moderate cellularity: predominantly a single cell pattern, small clusters
  • Single cells are round to polygonal with marked nuclear atypia
  • Multinucleated cells occasionally seen
  • Submembranous glycogen vacuoles have been described
  • Nuclei may be round to oval, with irregular clumped chromatin and prominent nuclei
  • Mitoses may be seen
  • Differential diagnosis: adenocarcinoma (usually 2 populations are seen); malignant epithelial cells with reactive mesothelium
Positive stains
Negative stains
Electron microscopy description
  • Long, slender microvilli on cell surface and intracytoplasmic lumina
  • Tonofilaments in paranuclear location and at outer zone of cytoplasm, with displacement of other organelles to paranuclear location
Molecular / cytogenetics images

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Comparative genomic hybridization

Differential diagnosis
Additional references
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