Journal of Pathology and Translational Medicine

Case Study

A Giant Peritoneal Loose Body: Hyun-Soo Kim, Ji-Youn Sung, Won Seo Park, Youn Wha Kim; Korean J Pathol. 2013;47(4):378-382. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.378

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Peritoneal loose bodies (PLBs) are usually discovered incidentally during laparotomy or autopsy. A few cases of giant PLBs presenting with various symptoms have been reported in the literature. Here, we describe a case of a giant PLB incidentally found in the pelvic cavity of a 50-year-old man. Computed tomography revealed a free ovoid mass in the pelvic cavity that consisted of central dense, heterogeneous calcifications and peripheral soft tissue. The mass was an egg-shaped, hard, glistening concretion measuring 7.5×7.0×6.8 cm and weighing 160 g. This concretion consisted of central necrotic fatty tissue surrounded by concentrically laminated, acellular, fibrous material. Small PLBs usually do not require any specific treatment. However, if PLBs cause alimentary or urinary symptoms due to their large size, surgical removal may be recommended. It is essential for clinicians to be aware of this entity and its characteristic features to establish the correct diagnosis.

Citations

Citations to this article as recorded by

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Original Article

Fine needle aspiration cytology of malignant epithelial mesothelioma of the peritoneum.: Sun Hee Sung, Kwang Gil Lee; Korean J Cytopathol. 1991;2(1):43-50.

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Abstract PDF: A case of malignant epithelial mesothelioma of the peritoneum diagnosed by fine needle aspiration cytology is described. The smear showed many individually scattered or clustered large round malignant epithelial cells intermingled with relatively small nonneoplastic mesothelial and mesenchymal cells. Papillary configurations with thick fibrous core were also seen. The malignant cells were virtually reminiscent of reactive mesothelial cells but they were larger in size and had more prominent nucleoli and more frequent binucleated or multinucleated cell formations than reactive mesothelial cells. The characteristic features of malignant cell of mesothelioma compared with the metastatic adenocarcinoma were relatively uniform cellular size, prominent round nucleoli, large round vesicular nuclei with finely granular chromatin pattern, smooth nuclear membrane, abundant glassy cytoplasm rather than bubbly mucin-containing cytoplasm and fuzzy cell border.

Case Reports

Well-Differentiated Papillary Mesothelioma of the Peritoneum: Report of a case.: Ji Eun Kim, So Duk Lim, Kyu Rae Kim, Han Young Choi; Korean J Pathol. 1996;30(7):646-648.

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Abstract PDF: We described a case of well differentiated papillary mesothelioma (WDPM) of the peritoneum in a 68-year-old man because of its rarity. It was incidentally found during operation for renal cell carcinoma. Grossly, the tumor appeared as multiple small granules or nodules on the entire peritoneal surface, including serosa of the intestine, omentum and mesentery. Microscopically, characteristic features are papillary, tubulopapillary or solid architecture lined by single layer of uniform, cytologically bland, cuboidal or polygonal mesothelial cells. The tumor cells were positive for EMA, cytokeratin and vimentin, but negative for CEA on immunohistochemical staining. Ultrastructural study showed characteristic long slender microvilli on the surface and intercellular junctions.

Retroperitoneal Duplication Cyst Associated with Heterotopic Pancreas: A case report.: So Yeong Oh, Myoung Ja Chung, Dong Geun Lee, Ho Yeul Choi; Korean J Pathol. 1998;32(9):687-690.

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Abstract: Occurrence of a retroperitoneal duplication cyst associated with a heterotopic pancreas is rare. We report a case of a retroperitoneal duplication cyst associated with a heterotopic pancreas. A 35-year-old male was admitted, presenting with back pain. A pelvic computed tomographic scan disclosed a 10 cm-sized cystic mass filling the lower pelvis and displacing the rectosigmoid colon anteriorly. Histologically, the cyst wall was lined partly by mucin-secreting columnar epithelium, showing atypical hyperplasia and partly by a gastric fundic-type and a colonic-like mucosa. Beneath the epithelium, organized bundles of smooth muscle were arranged in two layers analogous to smooth muscles layers of the bowel and a small piece of pancreatic tissue were present in the smooth muscle wall of the cyst.

Well-Differentiated Papillary Mesothelioma of the Peritoneum: A case report .: Yi Kyeong Chun, Yee Jeong Kim, Sung Ran Hong; Korean J Pathol. 1998;32(9):697-699.

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Abstract: Well-differentiated papillary mesothelioma (WDPM) of the peritoneum is considered to be a distinct subtype of peritoneal mesothelioma and has mostly behaved in a benign fashion. We report a case of WDPM in a 48-year-old-woman. It was incidentally found during a hysterectomy for a uterine cervical carcinoma. Grossly, the tumor was composed of multiple peritoneal nodules, measuring up to 2 cm. Microscopically, the nodules showed well-developed papillae lined by a single layer of cuboidal mesothelial cells. Immunohistochemical staining revealed a positive reaction for cytokeratin and a negative reacion for carcinoembryonic antigen and Leu-M1. Ultrastructurally, the tumor cells showed numerous long, slender microvilli and desmosomes.

Epithelioid Leiomyosarcoma of Retroperitoneum: A case report.: Myeng Sun Park, Ji Young Seo, Hae Jin Jeong, Bang Hur, Man Ha Hur; Korean J Pathol. 1999;33(2):141-144.

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Abstract: Epithelioid smooth muscle tumor is relatively rare and potentially malignant, especially in retroperitoneum. Distinct criteria for malignancy still have not been clarified in this epithelioid variant arising in retroperitoneum. We report a deceptively benign-appearing epithelioid leiomyosarcoma in a 50-year-old female. She was admitted with abdominal discomfort and dysuria. Abdominal CT showed a well-demarcated, 10 10 cm sized, solid mass in retroperitoneum. Concomitant metastatic lesions were noted in right lung field. Surgical excision of retroperitoneal mass and right lung lobectomy were performed. The retroperitoneal mass showed yellowish-tan, well-delineated and lobulated appearance. Histologically, this tumor was composed of predominantly epithelioid, round to oval cells with distinct clear cytoplasm and slightly atypical nuclei. Mitosis was rare (0~1/50 HPF). Lung lesions were morphologically similar to that of retroperitoneum.

Localized Malignant Mesothelioma of Peritoneum Arising in the Liver Capsule: A Case Report.: Hae Joung Sul, Dae Young Kang; Korean J Pathol. 2003;37(1):74-77.

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Abstract PDF: Mesothelioma originates in several sites including the pleura, peritoneum, pericardium, and tunica vaginalis. The pleura is the most common site of origin, but cases originating in the per- itoneum is relatively rare. Mesothelial lesions of the peritoneum may pose significant diagnostic problems. Yet, the accurate identification of this lesion is important because of its distinctive behavior and treatment modality. We herein report a case of malignant mesothelioma of the peritoneum arising in the capsule of the liver. The accuracy of our diagnosis has been confirmed by the immunohistochemical study and electron microscopic examination.

Fine Needle Aspiration Cytology of Retroperitoneal Paraganglioma with an Unusual Pattern: A Case Report.: Jean A Kim, Young Shin Kim, Chang Suk Kang, An Hi Lee, Byung Kee Kim, Sang In Shim, Sun Moo Kim; Korean J Cytopathol. 1994;5(1):74-78.

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Abstract PDF: A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features.

Cytologic Features of Metastatic Retroperitoneal Seminoma: A Case Report.: Mi Seon Kwon, Eun Joo Seo, Young Shin Kim, Chang Suk Kang, Sang In Shim; Korean J Cytopathol. 1995;6(1):71-75.

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Abstract PDF: A fine needle aspiration biopsy specimen of a retroperitoneal mass in a 26-year-old man who had had an orchiectomy for seminoma was submitted for cytologic evaluation. Cytologic features of the specimen included uniform neoplastic cells found singly or in groups of several cells intermingled with lymphocytes in a characteristic foamy, lacelike background. These cells varied from 10 to 20 m in diameter. The nuclei were round to ovoid with fine or reticular chromatin and one or more prominent nucleoli. The poorly defined cytoplasm stained pale-blue or blue with cytoplasmic vacuoles. The cytologic appearance was consistent with seminoma. Documented reports of the cytological appearance of seminoma are rare. The diagnosis of primary gonadal seminoma by fine needle aspiration biopsy is probably not indicated since the treatment of a primary gonadal tumor, regardless of its histogenesis, requires surgical resection. However, fine needle aspiration biopsy is extremely valuable in the diagnosis of extragonadal as well as metastic and recurrent seminoma.

Schwannoma of the Adrenal Gland: A case report.: Yong Chan Chun, Sun Hee Sung, Chan Il Park; Korean J Pathol. 1993;27(4):424-426.

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Abstract PDF: Retroperitoneum is often the site of occurrence of schwannoma, but reports on schwanoma of the adrenal gland is exceptional and only 4 cases have been documented in the literature. This report is to add one such case occurred in a 53 year-old male who had anorexia, nausea and indigestion for one month. Whole body bone scan and abdominal CT scan revealed a 10 cm sized solid mass at upper pole of the left kidney. Under the impression of renal cell carcinoma, an operation was performed. The tumor was well encapsulated and appeared not to involve the kidney. The cut surfaces were light yellow and seemed to be composed of several hard lobules with areas of mucoid, cystic and calcific changes. No adrenal gland was identified grossly. But microscopically, the tumor was found to be partly surrounded by a small portion of adrenal cortical tissue. Histologically the tumor was a typical schwannoma with Verocay bodies, although modified in some extents by mucoid degeneration, cystic change, hyaline change and focal calcification. It is worthwhile to remember that the retroperitoneal schwannoma commonly had a huge size, sometimes involving the adjacent structures.

Retroperitoneal Mucinous Tumor: Report of two Cases.: Eun Kyung Kim, Seong Ran Hong, Hy Sook Kim, Young Hyeh Ko, Jung Dal Lee; Korean J Pathol. 1992;26(6):632-634.

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Abstract PDF: Primary retroperitoneal mucinous tumor is very rare. In the worldwide literature, only 14 cases have been reported. Herein, we report two cases of retroperitoneal mucinous tumor found at laparotomy. The patients were females, aged 24 and 21 years, respectively. They had bilateral normal ovaries. Histologically, one was mucinous cystadenoma and the other showed borderline histology. The connective tissue wall resembling ovarian stroma was noted in one case. The pathogenesis was discussed.

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