Qap (Anatomical Pathology) 

QAP Peer Review

AP321
Case History: F/62. Massive ascites with extensive tumour nodules covering pelvic and abdominal peritoneum. No primary tumour detected in gastrointestinal or gynaecological tracts
Intended diagnosis: Primary peritoneal serous carcinoma, low grade. Contributed by:MW
Code Diagnosis Comment Score
anonymous Serous borderline tumour, peritoneal origin (100%) nil  80
anonymous Well differentiated papillary mesothelioma nil  20
anonymous Primary peritoneal serous carcinoma p53 positivity by immunostaining will favour high-grade serous carcinoma.  95
anonymous Primary peritoneal low grade serous adenocarcinoma 80% Well differentiated papillary mesothelioma 20% Immunostaining for BerEP4, MOC31 (for serous carcinoma) and Calretinin, CK5/6 (for mesothelioma)  100
anonymous Primary peritoneal serous papillary carcinoma 100%. DDX malignant mesothelioma is BerEP4- and calretinin+.  95
anonymous Primary peritoneal serous carcinoma, low-grade nil  100
anonymous Serous Borderline Tumour of the Peritoneum 50% Well Differentiated Papillary Mesothelioma of the Female Peritoneum 50% nil  50
anonymous Primary papillary serous adenocarcinoma of peritoneum 50% Well differentiated papillary mesothelioma 40% Malignant mesothelioma 10% perform immunostain for epithelial markers and mesothelial markers and more sampling  75
anonymous low grade peritoneal papillary serous carcinoma nil  100
anonymous Peritoneal Serous Borderline Tumor (absence of invasion) Differential diagnosis - Well differentiated Papillary Mesothelioma. nil  50
anonymous Abdominal/Pelvic peritoneum - Well-differentiated papillary tumor Differential diagnoses include WELL-DIFFERENTIATED PAPILLARY MESOTHELIOMA and PRIMARY SEROUS PAPILLARY TUMOR OF PERITONEUM (SEROUS PSAMMOCARCINOMA OF PERITONEUM). Suggest panel of immunohistochemical stains including calretinin, MOC-31, Ber-EP4 for differentiation of these two entities.  75
anonymous Primary peritoneal adenocarcinoma. nil  90
anonymous Epithelioid malignant mesothelioma. (100%) Immunohistochemical staining for mesothelial markers (calretinin, CK5/6, WT1 and D2-40) would be performed.  50
anonymous malignant mesothelioma (90%), need to exclude primary peritoneal serous tumor (10%) by immunostaining (e.g. calretinin, BerEP4, PAX8) nil  60
anonymous Peritoneum - Low grade peritoneal serous carcinoma (100% probability). nil  100
anonymous Mesothelioma nil  20
anonymous primary peritoneal serous carcinoma 100% nil  95
anonymous DDx includes well-differentiated papillary mesothelioma (60%) and low grade serous carcinoma (40%), need to confirmed by immunohistochemical study nil  75