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pleural mesothelioma
Wednesday 26 September 2012
pleural mesothelial neoplasia
Digital cases
epithelial mesothelioma
- JRC:9779 : pleural epithelial mesothelioma.
- JRC:9808 : pleural epithelial mesothelioma.
- JRC:9810 : pleural epithelial mesothelioma.
- JRC:9814 : pleural epithelial mesothelioma.
- JRC:9816 : Pleural epithelioid mesothelioma.
- JRC:9836 : Pleural epithelioid mesothelioma.
- JRC:9837 : Pleural epithelioid mesothelioma, invading the chest wall.
fibrous mesothelioma
- JRC:9781 : pleural fibrous mesothelioma.
- JRC:9785 : pleural fibrous mesothelioma.
- JRC:9789 : pleural fibrous mesothelioma.
- JRC:9790 : pleural fibrous mesothelioma.
- JRC:9792 : pleural fibrous mesothelioma.
- JRC:9811 : pleural fibrous mesothelioma.
- JRC:9815 : Pleural fibrous mesothelioma.
- JRC:9835 : Pleural fibrous mesothelioma.
pleural mesothelioma (NOS)
- JRC:9807 : pleural mesothelioma (NOS).
Immunochemistry
calretinin+ EMA+ (membranous staining) CK5/6+ ACE- TTF1-
Antigenic markers that support a diagnosis of mesothelial neoplasia EMA+ (strong and diffuse immunostaining) p53+ (sensitive but not specific) BCL2+ (insensitive but specific) desmin− (90%)
Molecular biology
BAP1 mutations
- BAP1-mutated mesothelioma
Molecular diagnosis
In 2014, there are no definitive molecular profiles that can distinguish a diagnosis of malignant mesothelioma from AEMH. However, progress continues to be made in this important area, and molecular analysis may prove to have a role in the diagnosis of malignant mesothelioma.
Cytogenetics
p16 FISH deletion in surface epithelial mesothelial proliferations is predictive of underlying invasive mesothelioma. (24503757)
Checklists
Consider clinical and radiographic features Encourage surgeon to sample generously Assess characteristics of inflammation Assess morphologic features of mesothelial proliferation Assess evidence of unequivocal pleural stromal invasion or chest wall invasion Judicious application of immunostains Refer difficult cases for consultation
See also
mesotheliomas
References
p16 FISH deletion in surface epithelial mesothelial proliferations is predictive of underlying invasive mesothelioma. Hwang H, Tse C, Rodriguez S, Gown A, Churg A. Am J Surg Pathol. 2014 May;38(5):681-8. doi : 10.1097/PAS.0000000000000176 PMID: 24503757