Papillary Mesothelioma

Papillary Mesothelioma

Papillary mesothelioma is a rare form of epithelioid mesothelioma. It is considered to have very little potential for becoming malignant; however, it does recur frequently.

These tumors develop extremely slowly, and patients with this form of mesothelioma have a good prognosis. There are some cases of papillary mesothelioma that are more aggressive, making it necessary for the patient to receive long-term follow up monitoring.

The majority of cases have that have been reported are in the abdominal cavity of women in their child-bearing years that have no history of asbestos exposure. There have been some reported cases of pleural papillary mesothelioma and papillary mesothelioma in the lining of the testes, some of which have been traced to asbestos exposure.

Histopathology

When these cells are examined under an electron microscope, they appear as grayish white nodules approximately 20 millimeters in length. Each structure has a distinct shape and contains a core filled with a mucous-like substance. They are lined by a single layer of cells that look like flattened cubes or columns. In some cases, the cells may penetrate into the layer of cells below the mesothelium, but if they do, the penetration is not very deep.

Study Shows how Unpredictable Papillary Mesothelioma can Be

In an article titled “Well-Differentiated Papillary Mesothelioma”, published in October 2001 in the American Journal of Surgical Pathology, researchers reported on 14 cases.

The breakdown of the cases was as follows:

• Seven originated in the pleura
• Six originated in the abdominal cavity
• One originated in the lining of the testes

Eleven of the patients were men and three were women, ranging in age from 32 years old to 82 years old. Only six of the patients had a verifiable history of asbestos exposure.

Follow up was conducted in nine of the cases, and the results showed that:

• In six patients, the disease was not active
• In one patient, the disease was cured after surgery and chemotherapy
• In one patient, the disease was aggressive
• One patient died of other causes

The researchers concluded from these findings that the prognosis for papillary mesothelioma can be either good or poor, and that in some cases, it can be caused by exposure to asbestos.

Diagnosis

The disease is usually found accidentally during abdominal or pelvic surgery.

Chinese Researchers Report on a Form of Papillary Mesothelioma Found in Menopausal Women

In a study published online June 7, 2011 in Pathology and Oncology Research, doctors from the People’s Republic of China reported on 22 cases of primary peritoneal serous papillary carcinoma (PPSPC), a variation of papillary mesothelioma that occurs in the abdominal cavity of postmenopausal and elderly women.

The average age of these women was 56 years old, and the most common symptoms they displayed were fluid buildup in the abdomen and swollen abdomens. Eighteen of these patients were treated with surgery to remove as much of the tumor as possible. All of the patients received chemotherapy. The overall survival rate was 21 months.