Small bowel (small intestine) – Benign cystic mesothelioma #benign #cystic #mesothelioma

Small bowel (small intestine)

Benign tumors and tumor-like conditions

Benign cystic mesothelioma

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 19 December 2012, last major update August 2012
Copyright: (c) 2003-2012,, Inc.

Also called multicystic mesothelioma
Rare tumor NOT associated with asbestos, occurs most frequently in women of reproductive age, difficult to diagnose preoperatively ( J Med Case Reports 2010;4:385 )

Often associated with prior pelvic surgery, endometriosis or pelvic inflammatory disease ( J Obstet Gynaecol Res 2011;37:1126 )
Some cases may be neoplastic, others may be caused by inflammation and adhesions ( Int J Gynecol Pathol 2011;30:163 ).
Complete surgical resection recommended; follow up is necessary, because 50% of tumors recur after excision

36 year old woman with multiple small cystic lesions in small bowel mesentery and pelvic peritoneum ( Case of the Week #205 )

Usually large, may be multifocal or unilocular; free floating cysts may also occur

23 year old woman: multiple adherent cysts

Cysts are thin-walled, may contain eosinophilic fluid
Mesothelial cells lining the cysts vary from flattened to endothelial-like to cuboidal
Inflammatory cells are often present within stroma between cysts
Foci of mesothelial hyperplasia may be present

Mesothelial cells lining cyst are keratin+, calretinin+ ( Hum Pathol 2003;34:369 ).

Ascitis, loculated: usually has irregular borders, is surrounded by bowel loops or abdominal / pelvic organs
Cystic teratoma: usually contains adipose and calcifications
Lymphangioma: younger patients, may contain chylous fluid grossly, often lymphoid aggregates and smooth muscle within walls, D2-40+
Other mesenteric / omental cysts / pseudocysts: usually unilocular, no distinct cyst wall or internal septa, keratin-, calretinin-
Pseudomyxoma peritonei (mucinous peritoneal metastasis): may have coexisting omental caking, soft-tissue peritoneal nodules, and scalloping of the serosal margins of the liver or spleen

End of Small bowel (small intestine) > Benign tumors and tumor-like conditions > Benign cystic mesothelioma

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