Metastasis of a pleural mesothelioma to a hyperplastic stomach polyp: an increase of vimentin expression is seen during a gain in deciduoid morphology

Our plain-English summary of Metastasis of a pleural mesothelioma to a hyperplastic stomach polyp: an increase of vimentin expression is seen during a gain in deciduoid morphology, by A. Soltermann, J.C. Pache, P. Vogt (Rare Tumors, 2011).

The study

• Authors: A. Soltermann, J.C. Pache, P. Vogt
• Journal: Rare Tumors
• Published: 2011;3(4):e52
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Deciduoid mesothelioma is a rare variant of the epithelioid histotype spectrum, resembling decidua of gravid uterus. It is found in the peritoneum of young women, but also in the pleura of elderly people. Histotype plasticity from epithelioid to sarcomatoid mesothelioma may be considered as epithelial-mesenchymal transition (EMT). A full autopsy was performed and mesothelioma infiltrates were analysed by immunohistochemistry. The metastasis of an epithelioid pleural mesothelioma to a hyperplastic polyp of the stomach is presented in this autopsy case. Deciduoid morphology increased during tumour progression and metastasis. The increase in eosinophilic cytoplasm correlated with the upregulation of the intermediate filament vimentin. High expression of vimentin was found in both central and superficial periglandular regions of the polyp. High vimentin expression also can occur in epithelioid rather than sarcomatoid differentiation. Thus, although vimentin is considered to be the major EMT marker, additional pathways must regulate its expression.

In plain English

This case report described one patient: a 75-year-old man with a smoking history of 20 pack-years and probable occupational asbestos exposure as a precision mechanic. An epithelioid pleural mesothelioma of the left pleural cavity was diagnosed by thoracoscopy, and the patient died 51 months after diagnosis. At autopsy, the authors found a metastasis inside a hyperplastic stomach polyp with a 4 cm head. The first biopsy showed no particular deciduoid features (tumour cells with abundant glassy cytoplasm) and only weak, focal staining for the protein vimentin. At autopsy, the pleural tumour showed partial deciduoid features, which were more pronounced in the polyp metastasis. Vimentin staining was much stronger in the polyp than in the pleura. Enriched lung dust contained 7 ferruginous bodies per gram wet weight and few mineral fibres, including the amphibole asbestos types crocidolite and anthophyllite. The authors concluded that, although vimentin is considered the major marker of epithelial-mesenchymal transition, other factors must regulate its expression.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single autopsy case)
• Who was studied: One patient, a 75-year-old man, with an epithelioid pleural mesothelioma of the left pleural cavity. The authors worked at hospitals in Zurich and Geneva, Switzerland.
• Exposure: Probable occupational asbestos exposure as a precision mechanic, plus a smoking history of 20 pack-years. No fiber types or doses are given for the work exposure.
• Main results:
  • Tumour progression was detected 40 months after diagnosis, and the patient died 51 months after diagnosis.
  • At autopsy, a metastasis was found in a pedunculated stomach polyp with a 4 cm head diameter.
  • On the initial biopsy, tumour cells were only weakly and focally positive for vimentin.
  • At autopsy, several sections of the primary pleural tumour showed partial deciduoid differentiation.
  • Deciduoid differentiation was even more pronounced in the stomach polyp metastasis.
  • Vimentin expression was much stronger in the polyp than in the pleura, and was equally distributed in the surface and central parts of the polyp.
  • In the polyp, mesothelioma cells near the surface showed focal pan-cytokeratin and calretinin, while the centre lacked these markers.
  • Enriched lung dust contained 7 ferruginous bodies per gram wet weight. Ordinary stained lung sections showed none.
  • Element analysis found few mineral fibres, in particular titanoxide (rutile) and the amphibole asbestos types crocidolite and anthophyllite.
  • The authors considered it more likely that a metastasis in the stomach wall developed and ulcerated, followed by polyp formation.
• The authors' conclusion: The authors concluded that, although vimentin is considered the major marker of epithelial-mesenchymal transition (EMT), other factors besides EMT signalling must regulate its expression. They added that vimentin can be associated with epithelioid rather than sarcomatoid differentiation.

Topics

Medical terms in this study, explained in our Lexicon: Metastasis, Pleural Mesothelioma, Mesothelioma, Epithelioid, Peritoneum, Pleura, Sarcomatoid, Autopsy.

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• Mesotheliomas with deciduoid morphology: a morphologic spectrum and a variant not confined to young females — J.H. Shanks, M. Harris, et al. (2000)
• Expression of HGF/SF in mesothelioma cell lines and its effects on cell motility, proliferation and morphology — P. Harvey, A. Warn, et al. (1998)
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• Hyperplastic mesothelial cells in lymph nodes: report of six cases of a benign process that can stimulate metastatic involvement by mesothelioma or carcinoma — P. Argani, J. Rosai (1998)

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