Mesothelioma is a neoplasm arising from the mesothelial cells lining the serous membrane such as pleura, peritoneum. and tunica vaginalis of testis. Primary malignant mesothelioma of tunica vaginalis is rare and there was no report in Korean literature yet. We report a case of a 43-year-old man with a painless palpable growing mass and histopathologically demonstrated to a malignant mesothelioma arising from the tunica vaginalis of testis.
Adult ; Humans ; Mesothelioma* ; Peritoneum ; Pleura ; Serous Membrane ; Testis*

Malignant pleural mesothelioma (MPM) is a tumor of mesodermal origin that arises from the serosa of the pleura, peritoneum, pericardium or tunica vaginalis. MPM is well known to have a poor prognosis with a median survival time of 12 months. Accurate diagnosis, staging and restaging of MPM are crucial with [18F] flurodeoxy-D-glucose positron emission tomography (FDG PET/CT) playing an increasingly important role. Here we report a case of MPM with unusual contiguous soft tissue spread of the tumor along the dermal and fascial planes characterized by PET/CT. Given that the loco-regional tumor in the thorax was under control on PET/CT, the death of the patient was most likely associated with physiologic or metabolic causes associated with an extra-thoracic tumor.
Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Mesoderm ; Mesothelioma ; Neoplasm Metastasis ; Pericardium ; Peritoneum ; Pleura ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Serous Membrane ; Thorax

Primary tumors arising from the spermatic cord are very rare. Mesothelioma derives from the mesothelial cells lining the serous membrane, such as the pleura, peritoneum, and tunica vaginalis of testis. Paratesticular malignant mesothelioma (MM), which usually presents as a hydrocele or intrascrotal mass, accounts for 0.3% to 1.4% of MMs. MMs of the spermatic cord account for less than 10% of paratesticular MMs. We report a case of MM of the spermatic cord in a 65-year-old man who primarily presented to the hospital with a left inguinal mass. Following the diagnosis after surgery, he was found to have a contralateral right inguinal mass and died in 6 months. Despite their rare occurrence in the spermatic cord, MMs need to be suspected, especially in patients with a history of asbestos exposure.
Aged ; Asbestos ; Humans ; Mesothelioma ; Peritoneum ; Pleura ; Serous Membrane ; Spermatic Cord ; Testis

Malignant mesothelioma of the peritoneum is a rare neoplasm with a rapidly fatal course. The tumour arises from the mesothelial cells lining the pleura and peritoneum or, rarely, in the pericardium or tunica vaginalis. This neoplasm is characterized by being difficult to diagnose, having a rapid evolution and a poor response to therapy. Mesothelioma is very glucose avid, and malignant pleural mesothelioma has been reported concerning the utility of F-18 FDG PET or PET/CT. But little has been known about the imaging finding of malignant peritoneal mesothelioma on F-18 FDG PET/CT. We report a case of malignant peritoneal mesothelioma mimicking peritoneal carcinomatosis of F-18 FDG PET/CT.
Carcinoma ; Glucose ; Mesothelioma ; Pericardium ; Peritoneum ; Pleura

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.
Diagnosis ; Liver* ; Mesothelioma* ; Pericardium ; Peritoneum* ; Pleura

This study was undertaken to identify the causative factors that predispose to early postoperative intestinal obstructions after the radical resection due to colorectal cancer, and to determine their preventive operative techniques. The records of 722 patients that had undergone radical resection due to colorectal cancer at the Department of General Surgery, Kangbuk Samsung Hospital, between January 1, 1986 and December 31, 1995, were reviewed. Among them, operative treatments due to early postoperative intestinal obstructions were performed in 39 patients(5.4%). The most common cause of intestinal obstruction in early postoperative period was bowel adhesion, that was developed in 20 cases(51.3%), and next common cause was internal herniation of bowel into the space between colostomy loop and lateral peritoneal wall(3 cases, 7.7%), incarcerated herniation of small bowel into the reperitonealized pelvic cavity(3 cases, 7.7%), pelvic abscess(1 case, 2.6%), and unknown causes(9 cases, 23.1%) in descending frequency. Use of closed suction drains was responsible to development of the 3rd and 4th causes. As a result, during the radical resection due to colorectal cancer, meticulous manupulation of bowels not to injure the bowel serosa, reperitonealization of pelvic floor at narrow interval with inversion of its dissected edge, complete closure of the space between colostomy loop and lateral wall of peritoneum, and adequate alternative use of closed suction drain and natural drain according to the operative condition, should be considered. In conclusion, surgeons should pay more attention to the operating procedures to lower the incidence of early postoperative intestinal obstruction.
Colorectal Neoplasms ; Colostomy ; Humans ; Incidence ; Intestinal Obstruction* ; Pelvic Floor ; Peritoneum ; Postoperative Period ; Serous Membrane ; Suction

The popularization of the multidisciplinary treatment has brought more demands to the radiological evaluation of the gastric cancer, which includes staging and response evaluation. Limited by the resolution, the present imaging modalities can not demonstrate tiny structures of the serosa, and the employment of the hyperattenuating serosa sign may improve the diagnostic performance of T4a. The spectral CT and diffusion weighted MRI may provide new potential methods for the staging of gastric cancer. Attention should be paid to the unresectable signs caused by the dispersed infiltration of adjacent fat space to the organs. The comprehensive evaluation of peritoneal metastasis should base on the sites and early signs. Diffusion weighted MRI may provide new indicator for the response evaluation of gastric cancer to neoadjuvant chemotherapy.
Diffusion Magnetic Resonance Imaging ; Humans ; Neoplasm Staging ; Peritoneum ; Serous Membrane ; Stomach Neoplasms

BACKGROUND: Malignant mesothelioma (MM) is a rare malignant neoplasm occurring in pleura, pericardium, and peritoneum. The differential diagnosis between MM and metastatic adenocarcinoma (MA) causes diagnostic, staging, and therapeutic dilemmas. Herein, we investigated characteristic cytologic features of MM. METHODS: Cytologic specimens of MM (n=10), MA (n=25), and reactive mesothelial hyperplasia (n=10) were retrieved and reviewed from archival materials in the Department of Pathology, Seoul National University Bundang Hospital from May 2003 to July 2008. RESULTS: MM showed tumor cell clusters and singly scattered malignant tumor cells forming single cell populations with sparse reactive benign mesothelial cells. In contrast, MA showed distinct two cell populations of tumor cell clusters and scattered reactive mesothelial cells. Furthermore, MM frequently exhibited a characteristic long chain-like arrangement (hand-in-hand appearance) and intercellular windows, which were rarely evident in MA. Variable nuclear size, relatively consistent nuclear-cytoplasmic ratio, bior multi-nucleation, and lacy cytoplasmic borders were also frequently observed in MM. CONCLUSIONS: Differential diagnosis of MM from MA in body fluids is possible based on meticulous examination of certain cytologic parameters, which could have significant implications in staging and treatment.
Adenocarcinoma ; Body Fluids ; Cytoplasm ; Diagnosis, Differential ; Hyperplasia ; Mesothelioma ; Pericardium ; Peritoneum ; Pleura

Anatomical plane and fascia have been described in medical behaviors for hundreds of years since the appearance of anatomy and operation. Generally, these descriptions can be sorted into three theories, i.e. plane surgery, fascia theory and mesentery anatomy. However, these theories are difficult to satisfy the scientific paradigm that includes consistency in description, independence in validation, potential to solve practical problems, and the interaction of the above-mentioned theries. Recently, membrane anatomy was proposed as the anatomy of mesentery and its beds in broad sense. Behind it lies fascia membrane/serous membrane structure, as well as inherent life events and general order. Mesentery in broad sense is described as the fascia membrane/serous membrane in serous cavity, which envelops and suspends the organ/tissue and its feeding structures to the posterior wall of the body. Anatomy is the setting/structure, in which life events/functions occur. In the research and discussion of membrane anatomy, abiding by the scientific paradigm and upholding the scientific spirit are the only way to obtain reliable knowledge and the criterion for in-depth scientific research.
Fascia ; Humans ; Mesentery ; Serous Membrane

A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.
Animals ; Cats ; Child, Preschool ; Diaphragm ; Hernia, Diaphragmatic ; Humans ; Liver ; Membranes ; Pleura ; Rabeprazole ; Serous Membrane ; Tomography, X-Ray Computed