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PubMed1997

CT appearances of involvement of the peritoneum, mesentery and omentum in Wilms' tumor.

BACKGROUND: Peritoneal involvement by Wilms' tumor indicates stage III disease. CT is the single preferred modality in determining the extent and staging of Wilms' tumor; however, the CT appearances of Wilms' tumor involvement of the peritoneum have not been specifically addressed in the literature. OBJECTIVE: The objective of this study was to demonstrate the CT manifestations when there is involvement of the peritoneum, mesentery and/or omentum in Wilms' tumor. MATERIALS AND METHODS: Four cases of Wilms' tumor form the basis of this report. They were examined on Elscint CT scanners. RESULTS: Masses ("dropped metastases") in the pelvis were present in all four patients. Three patients had masses in the mesentery of the small bowel and sigmoid colon. Infiltration of the greater omentum was identified in two patients as a mantle of tumor separating bowel from the anterior abdominal wall. Ascites was present in two patients. In one patient broad-based solid masses of varying sizes were noted on the parietal and on the visceral surfaces of the peritoneum, and in a different patient a discrete mass was noted in the lesser omentum. CONCLUSION: The peritoneal spaces, recesses, ligaments and folds are invisible unless invaded by disease which is well demonstrated on CT.

Child↗
PubMed1989

Activation of immunocompetent cells in the peritoneum of patients treated with CAPD.

Chemiluminescence and flow cytometry, employing a number of monoclonal antibodies, was used to investigate activation of immunocompetent cells in the blood and peritoneum of patients treated with CAPD. Increased expression of HLA-DR and RFD7, both markers of macrophage maturation, was observed on peritoneal macrophages, 78% and 33.5% cells positive, when compared to blood monocytes, which were 46% and 5.3%, respectively (P less than 0.001). Macrophage chemiluminescent response to opsonized zymosan was greater than that of circulating blood monocytes in CAPD patients, whereas the inverse was true for normal controls. Enhanced expression of IL-2 receptor and surface IgG by peritoneal macrophages were 24.9% and 65.3% cells positive compared with monocytes, 5.7% and 12.3% (P less than 0.01), and also suggests their activation. There was a marked increase in the HLA-DR expression by peritoneal lymphocytes from CAPD patients (32% cells positive) compared with those from CAPD blood (13.8%), normal blood (11.3%) and normal peritoneal fluid (14.5%), P less than 0.001. This was partially accounted for by increased numbers of B cells (18%) and activated T cells bearing HLA-DR. TFR and IL-2 receptor expression by CAPD peritoneal lymphocytes was similar to that of blood lymphocytes, implying the lack of an organized immune response within the peritoneum. Taken together, these results suggest that peritoneal macrophages from CAPD treated patients have features of maturation and activation, while changes in the lymphocyte populations are compatable with the actions of IL-1, indicating activity of the cellular immune system within the peritoneum.

B-Lymphocytes↗
PubMed1997

Does closure of the peritoneum during caesarean section influence postoperative morbidity and subsequent bladder adhesion formation?

The charts of 100 patients who underwent a second lower segment caesarean section were reviewed. In 50 patients both the parietal and visceral peritoneum had been closed during the first and second caesarean sections and in the remaining 50 patients, it had been left open. The incidence of adhesions was found to be 28% in the closed group (n=50), compared with only 14% in the open group (n=50). Operative time was prolonged by closing the peritoneum, an average of 52.2 minutes in the closed group compared with 44.1 minutes in the open group, P < 0.05. The incidence of urinary tract infection, endometritis, wound infection and respiratory tract infection in the postoperative period was similar in both groups. We conclude that closure of the peritoneum at caesarean section is unnecessary and may in fact promote adhesion formation and so the simpler technique of leaving it open should be adopted.

Journal Article↗
PubMed2002

A novel approach for the increased delivery of pharmaceutical agents to peritoneum and associated lymph nodes.

A novel method for prolonging the retention of liposomes in the peritoneum while increasing liposome deposition in lymph nodes that drain the peritoneum is described. An aliquot (1 ml) of technetium-99m ((99m)Tc)-biotin-liposomes encapsulating blue dye was injected intraperitoneally in rats. Thirty minutes after administration of the (99m)Tc-blue-biotin-liposomes, five rats (experimental) were administered avidin (5 mg) intraperitoneally, whereas the remaining five rats served as controls. Scintigraphic images were acquired at baseline and 1 and 24 h after the liposome injection followed by a tissue biodistribution study. Images at 24 h clearly demonstrated very different distributions between the experimental and control animals. In experimental rats, most of the activity was visualized in the abdominal region, and in abdominal and mediastinal lymph nodes. The percentage of the injected dose (% ID) in the blood was significantly higher in the control group than in the experimental group (14.0 +/- 1.7 versus 0.17 +/- 0.03%; P < 0.001). The % ID in the spleen was also significantly greater for controls (23.3 +/- 3.9%) compared with the experimental group (0.78 +/- 0.8%; P = 0.001). Significant (99m)Tc activity was detected in blue-stained abdominal nodes (4.7%) and mediastinal nodes (2.3%) from the experimental animals, whereas no blue-stained nodes were detectable in the control animals. The intraperitoneal biotin-liposome/avidin delivery system described in this study could potentially be used for delivery of liposome-encapsulated drugs to disease processes that become disseminated in the peritoneum such as metastatic ovarian, gastric, and colorectal cancer, as well as infectious peritonitis.

Animals↗
PubMed1989

Cystic mesothelioma of the peritoneum.

Cystic mesothelioma (CM) of the peritoneum is a rare, benign neoplasm that occurs predominantly in women and tends to recur locally. It has received little attention (to our knowledge, a single case report) in the radiology literature. Five cases of CM are presented. Computed tomography (CT) was performed in three cases, ultrasound (US) in four cases, and magnetic resonance (MR) imaging in one case. Twenty-eight cases reported in the literature are reviewed for comparison. CM shows a clear predilection for the surfaces of the pelvic viscera but is seen in other areas of the peritoneum and retroperitoneum. The neoplasm was intraperitoneal in three cases and primarily retroperitoneal in the other two cases. In all CT and US studies performed, a single large, multilocular cystic mass was demonstrated. MR imaging, performed in one case, showed that the lesion had signal characteristics typical of a watery collection low in solute concentration. It is concluded that CM of the peritoneum has a nonspecific multilocular cystic appearance on images, which does not permit it to be differentiated from other cystic lesions.

Adult↗
PubMed2003

Nonclosure of the peritoneum at shunt insertion.

To evaluate the nonclosure of the peritoneum during insertion of the distal end of a ventriculoperitoneal shunt in the peritoneal cavity, 43 patients in whom a ventriculoperitoneal shunt was inserted using laparotomy with nonclosure of the peritoneum for insertion of the distal catheter were reviewed. No morbidity occurred during a follow-up period of 3-9 months. We think that nonclosure of the peritoneum is safe in shunt surgery, but needs to be evaluated in further studies.

Child, Preschool↗
PubMed1995

P-selectin/ICAM-1 double mutant mice: acute emigration of neutrophils into the peritoneum is completely absent but is normal into pulmonary alveoli.

Neutrophil emigration during an inflammatory response is mediated through interactions between adhesion molecules on endothelial cells and neutrophils. P-Selectin mediates rolling or slowing of neutrophils, while intercellular adhesion molecule-1 (ICAM-1) contributes to the firm adhesion and emigration of neutrophils. Removing the function of either molecule partially prevents neutrophil emigration. To analyze further the role of P-selectin and ICAM-1, we have generated a line of mice with mutations in both of these molecules. While mice with either mutation alone show a 60-70% reduction in acute neutrophil emigration into the peritoneum during Streptococcus pneumoniae-induced peritonitis, double mutant mice show a complete loss of neutrophil emigration. In contrast, neutrophil emigration into the alveolar spaces during acute S. pneumoniae-induced pneumonia is normal in double mutant mice. These data demonstrate organ-specific differences, since emigration into the peritoneum requires both adhesion molecules while emigration into the lung requires neither. In the peritoneum, P-selectin-independent and ICAM-1-independent adhesive mechanisms permit reduced emigration when one of these molecules is deficient, but P-selectin-independent mechanisms cannot lead to ICAM-1-independent firm adhesion and emigration.

Animals↗
PubMedDate not supplied

[Multicystic mesothelioma of the peritoneum].

Benign multicystic mesothelioma (MCM) of the peritoneum is a rare lesion that occurs predominantly in middle aged women with previous history of pelvic surgery. We report a case of MCM of the peritoneum in a 25-year-old man in whom cystic masses were twice surgically removed in an interval of 1.5 year. Ultrasonography and computer assisted tomography of the abdomen revealed a multicystic abdominal and pelvic mass. At first laparotomy, a multiple, thin-walled cysts ranging 0.5-7 cm in diameter were found involving the abdominal and pelvic peritoneum. After removal of all visible cysts we made histopathological diagnosis of the multilocular cavernous lymphangioma, without immunohistochemical examinations. The recurrent tumor was clinically and pathologically identical, but the final diagnosis, established upon immunohistochemical staining, was MCM: the tumor cells were strongly positive for cytokeratin, weakly positive for vimentin, and negative for Factor VIII. Management of the MCM surgical excision, unfortunately not always curative, since there is a high recurrence rate.

Adult↗
PubMed2001

Papillary serous carcinoma of peritoneum: case study and review of the literature on the differential diagnosis of malignant peritoneal tumors.

The distinction between malignant mesothelioma and other malignant neoplasms diffusely involving the peritoneum is important for proper patient treatment. The extra-ovarian peritoneal serous papillary carcinoma is a rare, primary, multicentric peritoneal tumor that is morphologically identical to ovarian serous carcinoma of equivalent grade, but can spare or minimally involve the ovaries. We report such a tumor in a 65-year-old female who had abdominal swelling, ascites with positive cytology and a high grade of nuclear atypia in malignant cells as well as elevated serum CA125. Exploratory laparotomy findings of intrabdominal carcinomatosis were not accompanied by any evident primary site; so the diagnosis of a primary papillary serous neoplasia of the peritoneum was strongly considered. Since the amount of residual disease may be an important prognostic determining factor in primary papillary serous carcinoma of the peritoneum, the patient was debulked to no macroscopic disease and was then given platin-based chemotherapy. The tumor's differential diagnosis from malignant mesothelioma was based, apart from morphologic criteria, on the tumor's immunoreactivity to MOC-31, Ber-EP4 and TAG-72, as well as on the lack of immunostaining for keratin 5/6 and calretinin. Differential diagnosis from ovarian cancer was possible only after the pathological examination of the surgically resected ovaries; the tumor showed minimal superficial invasion of the ovarian cortex.

Aged↗
PubMed1999

[Diagnosis and differential diagnosis of primary carcinoma of female peritoneum].

OBJECTIVE: Histogenesis and morphological features of 6 primary carcinomas of female peritoneum were studied. METHODS: H&E staining, histochemical stainings and immunohistochemical stainings were used. RESULTS: Among 6 primary carcinomas there were 4 cases of serous papillary carcinomas, 1 case of endometrioid carcinoma and 1 case of transitional cell carcinoma. CONCLUSION: Primary carcinomas of the female peritoneum were histologically identical to that of the similar epithelial carcinomas arising from the ovaries. The diagnosis was made only when the ovaries are not involved and without no any evidence of similar epithelial carcinoma obtained in the ovaries, uterus or urinary organs. These tumors are considered arising from the secondary Mullerian system. D-PAS and CEA staining are helpful as the accessory criteria for the differential diagnosis between primary carcinoma of the peritoneum and malignant mesothelioma.

Adult↗
PubMed2002

[Primary well-differentiated papillary mesothelioma of the peritoneum--a rare but important differential diagnosis].

The primary well-differentiated papillary mesothelioma of the peritoneum is a rare neoplasm, characterized by an indolent course and good prognosis. We report the case of a 55-year-old male, who presented progressive abdominal swelling due to ascites. On computerized tomography, the peritoneum was diffusely thickened and irregular. Cytologic examination showed a lymphocyte rich ascitic fluid. Malignant cells could not be identified. On laparoscopy, numerous nodular lesions were observed on the peritoneal surface. A biopsy of the latter showed an unusual malignant growth. Using immunohisto-chemistry and electron microscopy, typical features of a well-differentiated papillary mesothelioma were recognized. The patient underwent tumor debulking. Two years later he is symptom free. This case study, much similar to another 38 reported cases in the MEDLINE database, illustrates the characteristic features of this rare malignancy that should be recognized and distinguished from other, common, more aggressive neoplasms involving the peritoneum.

Diagnosis, Differential↗
PubMed2002

[Short-term intraperitoneal infusion of cisplatin and OK-432 for a case of malignant mesothelioma of the peritoneum].

A case of malignant mesothelioma of the peritoneum successfully treated with short-term intraperitoneal chemotherapy is reported. A 67-year-old woman underwent laparotomy for ascending colon cancer. During, laparotomy, numerous mucoid nodules were found on the peritoneal surface, even though the colonic tumor did not invade the serosa. Ileocecal resection (D1) with partial omentectomy was performed. Intraperitoneal infusion with cisplatin (200 mg) was started immediately after surgery and additional cisplatin (150 mg) was administered with OK-432 (30KE). The serum level of CA125 rapidly decreased after the chemotherapy, and was normalized 3 months postoperatively. The histological diagnosis of the peritoneal lesions was malignant mesothelioma of the peritoneum (diffuse type). The patient is living without any evidence of recurrence 10 months postoperatively. These results suggest that this short-term chemotherapy is worth trying in cases of malignant mesothelioma of the peritoneum.

Aged↗
PubMedDate not supplied

In vivo effects of OK-432, inosine pranobex and its salt components on macrophage subpopulations in spleen and peritoneum of mice during the primary humoral immune response.

Subsets of macrophages (BM 8-, la- and esterase-positive subtypes) in the spleen and the peritoneum of mice were affected differently by immunomodulators during the humoral immune response. I.p. application of inosine pranobex (INPX), as well as of its salt moiety (DIPPACBA) and its dimethylaminopropanol (DIP) and acetamidobenzoic acid (PACBA) components, increased the number of nonspecific esterase-bearing cells in the peritoneum on day 3. INPX and DIPPACBA stimulated the la+ macrophage on day 3, DIPPACBA the BM 8+ macrophage only on day 1 and DIP on day 5. In spleen, DIP and PACBA had marked effects on the la+ subset in addition to a marginal effect on the BM 8+ phenotype on day 1. DIPPACBA also influenced the BM 8+ macrophage slightly on day 1. In contrast, the microbial product OK-432 stimulated BM 8+ and la+ macrophages in spleen markedly on day 1, but only marginally on days 3 and 5. However, it exerted a strong effect on both subtypes in peritoneum on days 3 and 5. OK-432 was found to be without any influence on esterase-bearing macrophages. The results show that the heterogeneity of macrophages is not only represented by subset markers, but also by their susceptibility to immunomodulators in different organs and stages of the immune response.

Animals↗
PubMed2003

Primary malignant mesothelioma of the peritoneum.

Mesothelioma of the peritoneum represents an extremely rare malignancy of the abdominal cavity and forms about 10% of all mesotheliomas. The annual incidence of the tumor in the general population is 1-2 cases per million. The causative relationship between chronic exposure to asbestos and mesothelioma has been proved. Since the symptomatology of the tumor is usually not specific, the diagnosis is made in the advanced stages of the disease, which is the limiting factor for therapy. Most patients die within 2 years from the diagnosis. We report a case of a primary malignant mesothelioma of the peritoneum in a 60-year old male, who presented with three-month history of ascites, weakness and appetite loss. The patient gave the information that he had been living for 15 years in a loft which was insulated by material consisting of asbestos. After investigations, primary neoplasm of the peritoneum was suspected, which was confirmed by the biopsy and the morphopathological examination. Due to the advanced spread of the tumor and the poor general condition, the patient underwent palliative therapy. The patient died 3 months after the diagnosis. Epidemiological data for chronic exposure to asbestos have to be considered as the etiological factor of disease in this particular patient.

Asbestos↗
PubMed2006

[Preliminary screening and identification of a peptide that binds specifically to gastric cancers cells with high metastasis to peritoneum].

OBJECTIVE: To screen and identify peptides that binds specifically to gastric cancers cells with high metastasis to peritoneum so as to find appropriate vectors for targeting therapy for cancer. METHODS: Human gastric cancer cells of the line GC9811 and those with high metastasis to peritoneum of the line GC9811-P were co-incubated with the 12-mer bacteriophage random peptide library. After 3 round of repeated screening, phage clones were collected. Forty internalized phage single-stranded DNA that specifically binding to the GC98112-P cells were sequenced. GC9811 and GC9811-P cells were co-inoculated with 5 peptides with the N end marked with fluorescein isothiocyanate (FITC) and 1 un-related peptide not binding to GC9811 and GC9811-P cells. Fluorescence microscopy, ELISA, and flow cytometry were used to detect the binding activity. BALB/cnu/nu mice were inoculated intraperitoneally with GC9811 and GC9811-P cells and then randomly divided into. 2 equal groups: experimental group, inoculated with the peptide PIII-FITC and control group (inoculated with un-related peptide PC-FITC. Forty-eight hours later the mice were killed and the peritoneum and tumor masses in different organs were collected and under fluorescence microscopy. RESULTS: DNA sequencing showed that 45% (18/45) of the isolated phages displayed repeated sequence SMSIASPYIALE, and SMSI was defined as a conservative motif. Obvious fluorescence was seen in the GC9811-P cells co-incubated with PIII-FITC and weak fluorescence was seen in the GC9811 cells co-incubated with PIII-FITC. Un-marked un-related peptide PC and PIII-FITC did not influenced the fluorescence staining of the GC9811-P cells, however, no fluorescence could be seen in the GC9811-P cells co-incubated with un-marked PIII and PIII-FITC. The fluorescence positive cell rate was 5.9% in the GC9811 cells co-incubated with PIII-FITC, and was 90.2% in the GC9811-P cells co-incubated with PIII-FITC. The fluorescence positive cell rates of the GC9811 cells and GC9811-P cells co-incubated with PC-FITC were 10.1% and 9.9% respectively 10.1% and 9.9% respectively. The fluorescence strength of the GC9811-P cells co-incubated with PIII-FITC was significantly greater than that of the GC9811-P cells co-incubated with PC-FTIC at any time-point and dose (all P < 0.01), and increased along with the increase of co-incubation time and dose of PIII-FITC. The peritoneal tumor tissues caused by the GC9811-P cells of the mice showed strong fluorescence and those caused by GC9811 cells only showed very weak fluorescence. Weak fluorescence could be seen in the tumor masses in the lymph nodes, liver, and muscle of the mice inoculated with GC9811-P cells and was not seen in the tissues of the mice inoculated with GC9811 cells. CONCLUSION: The sequence SMSIASPYIALE that specifically binds to human gastric cancer cells with high metastasis has been screened that has the potential to be used as a marker and targeting vector in diagnosis and treatment of gastric cancer.

Amino Acid Sequence↗
PubMed1991

Pathology of the peritoneum: a review of selected topics.

Mesothelial lesions of the peritoneum may pose significant diagnostic problems. Accurate identification of these lesions is important because of their distinctive behavior and treatment requirements. This review discusses the clinical, pathological, and differential diagnosis of a variety of mesothelial lesions of the peritoneum, which includes mesothelial hyperplasia, multilocular peritoneal inclusion cysts (benign cystic mesothelioma), well-differentiated papillary mesotheliomas, and diffuse malignant mesothelioma, and the role of immunohistochemistry in the distinction from the more common primary peritoneal serous carcinomas. In addition, borderline serous tumors, psammocarcinomas, and solitary fibrous tumors of the peritoneum are briefly mentioned.

Humans↗
PubMed1979

Production of antiviral and migration inhibitory activities in the peritoneum of mice after inoculation with allogenic Ehrlich ascites tumor cells.

Peritoneal inoculation of Ehrlich ascites cells into mice stimulates the appearance of migration inhibitory factor (MIF) not only in the peritoneum but also in the circulation of mice. Whereas the MIF-activity in the peritoneum reached maximum at 6 days and disappeared within 17 days, the MIF-activity of sera reached maximum levels at about 11 days after intraperitoneal inoculation of tumor cells (10(6) of EAC per mouse). In addition, an antiviral activity of peritoneal exudates was observed in the early stage (24--72 h) of tumor challenge. The time-course of appearance of both MIF and AV-inhibitor are presented. A significant decrease of MIF-activity was noted when the tumor-inoculated mice were treated with ds-RNA, antithymocyte serum and cyclophosphamide, respectively. The appearance of antiviral activity in the peritoneum of tumor-inoculated mice seems to be macrophage-dependent. Although the antiviral factor meets several criteria of interferons, further studies are required for its characterization.

Animals↗
PubMedDate not supplied

Gastric cancer with metastases to the distant peritoneum: a 20-year surgical experience.

BACKGROUND/AIMS: The efficacy of palliative gastrectomy in gastric cancer with peritoneal metastases remains uncertain. The aim of the present study was to evaluate the benefits of gastrectomy on the postoperative course of patients with gastric cancer and simultaneous metastases to the distant peritoneum. METHODOLOGY: A total of 122 patients who had gastric cancer and metastases to the distant peritoneum were studied with respect to survival. RESULTS: The extent of peritoneal metastases did not significantly affect the prognosis. Moreover, multivariate analysis indicated that surgery without gastrectomy was the only significant prognostic factor (relative risk, 2.587). CONCLUSIONS: Our results suggest that the decision to perform gastrectomy does not depend on the extent of peritoneal metastasis in gastric cancer. Furthermore, palliative gastrectomy, if feasible, seems to have a beneficial effect on the postoperative course and is indicated for patients regardless of metastasis to the peritoneum, if the primary tumor is surgically resectable and there is no evidence of liver metastasis.

Female↗