title: Mucinous Balls Tangled With Mesothelial Cells and MUC2-Positive Cancer Cells in the Ascites of Pseudomyxoma Peritonei.
abstract: Pseudomyxoma peritonei (PMP) is characterized by extensive mucinous ascites following rupture of mucinous neoplasms of an intra-abdominal origin, and contain secreted gel-forming mucins such as MUC2 and MUC5AC. We encountered a 66-year-old Japanese man complaining of abdominal distension. Ascites at the site was gelatinous upon gross examination, and needle aspirate smears showed histiocytes and many mucinous balls wrapped in spindle cells, which were positive for vimentin, pan-cytokeratin, and podoplanin. The cell block showed several adenocarcinoma clusters, which were positive for MUC2, MUC5AC, CK20, and CDX-2, and negative for CK7. From these findings, a diagnosis of PMP arising from colon cancer was indicated. Cytoreductive surgery was performed, and the cystic diverticulum was found to be infiltrated by tumor cells in the sigmoid colon that caused PMP. Mucinous balls surrounded by mesothelial cells and MUC2-positive adenocarcinoma cells are useful clues in the diagnosis of PMP. Diagn. Cytopathol. 2016;44:628-631. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Shizuka
authors.initials: S
authors.lastname: Akashi
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kuwabara
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Yasuda
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akutagawa
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeshita
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kurisu
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Egashira
authors.affiliation: Department of Pathology, Osaka Medical College, Osaka, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hirose
authors.affiliation: Department of Radiology, Osaka Medical College, Osaka, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Yuki
authors.affiliation: Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsuda
authors.affiliation: Department of Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D003110:Colonic Neoplasms / Q000473:pathology*; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D055262:Mucin-2 / Q000235:genetics / Q000378:metabolism*; D010534:Peritoneal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D011553:Pseudomyxoma Peritonei / Q000378:metabolism / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; C524625:MUC2 protein, human; D055262:Mucin-2
keywords: MUC2; ascites; mesothelial cell; mucinous ball; pseudomyxoma peritonei