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Benign mesothelial cells in mediastinal lymph nodes.
V Parkash1, M Vidwans, D Carter
1Department of Pathology, Yale University School of Medicine, New Haven, Connecticut 06520-8070, USA.
The American Journal of Surgical Pathology
|October 19, 1999
Summary
Benign mesothelial cells can appear in mediastinal lymph nodes, especially after pericarditis or pleuritis. These rare inclusions may mimic cancer but are not malignant.
Area of Science:
- Pathology
- Surgical Pathology
- Cytopathology
Background:
- Lymph node inclusions are typically aberrant glandular tissues.
- Nonglandular inclusions like nevus cells and decidua are rare.
- Mesothelial cell inclusions in lymph nodes are exceedingly rare.
Purpose of the Study:
- To investigate the incidence of benign mesothelial cells in mediastinal lymph nodes.
- To determine the association with a history of pericarditis or pleuritis.
- To evaluate diagnostic challenges posed by these inclusions.
Main Methods:
- Retrospective analysis of eight cases with mediastinal lymph node removal.
- Examination of hematoxylin and eosin-stained sections.
- Immunohistochemical staining including CAM 5.2, AE1/AE3, Ber-EP4, CEA, Leu-M1, B72.3, and S-100.
Main Results:
- CAM 5.2-positive mesothelial cells were found in five of eight cases.
- Cells were located in nodal sinuses, appearing as single cells or small clusters.
- These cells were often missed on routine H&E sections and can mimic metastatic carcinoma.
Conclusions:
- Benign mesothelial cells can embolize to regional lymph nodes following pleuritis or pericarditis.
- These cells are usually sparse and difficult to detect on routine sections.
- Distinguishing these benign cells from malignancy is crucial.