ABSTRACT
BACKGROUND: Papillary serous carcinoma of the peritoneum (PSCP) is a rare primary peritoneal tumor, described exclusively in women. It is believed to arise from the secondary müllerian system, which is comprised of the pelvic and lower abdominal mesothelial lining and subjacent (subcoelomic) mesenchyme in women. Both mesotheliomas and PSCP arise from the coelomic epithelium, but are clinicopathologically and biologically distinct entities. METHODS: The authors report clinicopathologic findings in a man, age 74 years, who died 3 months after the diagnosis of an extensive malignant abdominal disease. RESULTS: The routine histologic and immunocytochemical studies of tumor tissue, obtained during the patient's lifetime and at autopsy, validated the unique occurrence of PSCP in a man. CONCLUSIONS: This case illustrates that PSCP can occur in a man and that this diagnosis may be considered in the differential diagnosis of papillary serous tumors of the peritoneum in male patients. Although rare, PSCP is a diagnostically distinct entity the treatment of which is similar to ovarian serous tumors rather than mesotheliomas.
Subject(s)
Cystadenocarcinoma, Papillary/diagnosis , Peritoneal Neoplasms/diagnosis , Aged , Cystadenocarcinoma, Papillary/pathology , Humans , Immunohistochemistry , Male , Peritoneal Neoplasms/pathology , Sex FactorsABSTRACT
There is scant literature on the existence of IgE (type I allergic reactions) directed against Myocobacterium tuberculosis. To study this problem, total serum IgE (SIgE) and IgE specifically directed against the purified protein derivative of Myocobacterium tuberculosis (PPD-Sp IgE) was determined in 16 patients with AFB positive pulmonary tuberculosis (PTB) and their age and sex matched controls. Mean SIgE was significantly higher in PTB than in controls. Mild heating of the serum was necessary to detect the presence of PPD-Sp IgE which was positive in 81.3% PTB. One (6.3%) gave a class I, 9 (56.3%) gave class II and 3 (18.7%) gave class III RAST reactions. PPD-Sp IgE was absent in 3(18.7%). There were no class IV reactions. Control sera were negative for PPD-Sp IgE. Though the RAST test had a sensitivity of 80.1%, a specificity of 100% and a positive predictive value of 100%, we do not advocate this test as a diagnostic test. We have used this test to demonstrate the existence of PPD-Sp IgE and thus the existence of Type I allergic reactions against the PPD antigen of Mycobacterium tuberculosis. Its value in relation to clinical symptoms and its site of local production need further studies.
