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MICROSCOPIC: The nodules of gliomatosis peritonei are composed of haphazardly oriented, elongated mature glial cells in a fibrillary matrix, covered by mesothelial lining. Usually, there is associated chronic inflammation and fibrosis.
The differential diagnosis includes leiomyomatous peritonealis disseminata (LPD) in which one sees nodules of smooth muscle (small leiomyomas) scattered throughout the peritoneum and omentum. LPD may be seen in women who are pregnant or on oral contraceptives. It is positive for muscle markers and negative for GFAP, where as gliomatosis peritonei is strongly GFAP positive and SMA negative. S-100 protein is variably positive in gliomatosis peritonei.
The differential diagnosis includes leiomyomatous peritonealis disseminata (LPD) in which one sees nodules of smooth muscle (small leiomyomas) scattered throughout the peritoneum and omentum. LPD may be seen in women who are pregnant or on oral contraceptives. It is positive for muscle markers and negative for GFAP, where as gliomatosis peritonei is strongly GFAP positive and SMA negative. S-100 protein is variably positive in gliomatosis peritonei.