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Malignant peritoneal mesothelioma and Crohn disease
  1. Kelly J Butnor1,2,
  2. Elizabeth N Pavlisko1,
  3. Thomas A Sporn1,
  4. Victor L Roggli1
  1. 1Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
  2. 2Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, Vermont, USA
  1. Correspondence to Dr Kelly J Butnor, Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, 111 Colchester Ave., ACC Bldg., EP2-120, Burlington, VT 05401, USA; kelly.butnor{at}


Aims Mesothelial reaction simulating peritoneal diffuse malignant mesothelioma (MM) has been reported in the setting of Crohn ileitis. To our knowledge, peritoneal MM arising in patients with inflammatory bowel disease (IBD) has not been reported. The purpose of this study is to report the clinicopathological characteristics of patients with peritoneal MM and IBD.

Methods A database of approximately 3800 MM was reviewed for cases of MM in patients with IBD.

Results Three patients (0.08%) with peritoneal MM and Crohn disease (CD) were identified, including two women and one man ranging in age from 56 to 65 years. All had a long-standing history of diarrhoea and an established diagnosis of CD of 3 years or greater duration. Two had epithelial MM and one had biphasic MM. Only one had documented asbestos exposure.

Conclusions Peritoneal MM occurs rarely in patients with IBD, but interestingly, has only been observed in the setting of CD and not in patients with ulcerative colitis. Chronic inflammation has been associated with the development of MM in rare instances and these three cases suggest that CD with transmural inflammation may also be a precursor. The precise role of CD-related transmural inflammation in the carcinogenesis of peritoneal MM remains to be determined.


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  • Handling editor Cheok Soon Lee

  • Contributors KJB and VLR were involved in substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data and drafting the work or revising it critically for important intellectual content. All authors were involved in final approval of the version published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.