title: Well-differentiated papillary mesothelioma of the pleura: a series of 24 cases.
abstract: Well-differentiated papillary mesothelioma (WDPM) of the pleura represents a distinct mesothelial tumor presenting with unilateral pleural effusion and superficial spreading of stout papillary formations with myxoid cores, lined by bland, flattened, or epithelioid cells, without or with limited invasion of the submesothelial layer. The majority of cases have been reported in the peritoneum in women of reproductive age with no history of asbestos exposure and also in the tunica vaginalis of men. We report 24 cases of pleural WDPM and compared their histologic, epidemiologic, and clinical features with those of classic mesothelioma. Men and women were equally affected, with a mean age of 60 years. Half of the patients had a history of occupational asbestos exposure. In 11 patients with a minimal follow-up period of 24 months, the survival ranged from 36 to 180 months with an average of 74 months as compared with 9.89 months for 1248 paired patients with diffuse malignant mesothelioma. Ten-year survival was 30.8%. We conclude that WDPM is a rare and unusual mesothelial tumor, characterized by a lack of deep invasion and associated with an indolent clinical course and long survival. For these reasons, WDPM is best considered as a specific clinico-pathologic entity distinct from conventional diffuse malignant mesothelioma.
authors.affiliation: Department of Pathology CHU Caen, France. galateausalle-f@chu-caen.fr
authors.forename: Françoise
authors.initials: F
authors.lastname: Galateau-Sallé
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Vignaud
authors.forename: Louise
authors.initials: L
authors.lastname: Burke
authors.forename: Allen
authors.initials: A
authors.lastname: Gibbs
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Brambilla
authors.forename: Richard
authors.initials: R
authors.lastname: Attanoos
authors.forename: Marcel
authors.initials: M
authors.lastname: Goldberg
authors.forename: Guy
authors.initials: G
authors.lastname: Launoy
mesh_terms: D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000209:etiology / Q000473:pathology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects; D010997:Pleural Neoplasms / Q000209:etiology / Q000473:pathology*; D011379:Prognosis
chemical_list: D001194:Asbestos