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Recent Advances In The Diagnosis Of Malignant Mesothelioma: Focus On Approach In Challenging Cases And In Limited Tissue And Cytologic Samples

S. Monaco, M. Mehrad, S. Dacic
Published 2018 · Medicine

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Mesothelial proliferations can be diagnostically challenging in small specimens, such as body fluid cytology and small tissue biopsies. A great morphologic challenge for pathologists is the separation of benign reactive mesothelial proliferations from malignant mesotheliomas. Reactive mesothelial proliferations may have histologic features that resemble malignancy including increased cellularity, cytologic atypia, and mitoses. Recent advances in mesothelioma genetics resulted in identification of BAP1 mutations and p16 deletions as features of malignant mesotheliomas. Hence, BAP1 immunohistochemistry and fluorescence in situ hybridization for p16 emerged as 2 most common diagnostically helpful ancillary studies used on limited samples when the question is whether the proliferation is malignant or benign. In contrast, separation of mesothelioma from other malignancies is relatively straight forward using morphology and immunohistochemical stains. The choice of antibody panel to be applied in an individual case is driven by morphology, either epithelioid or sarcomatoid. This brief review will focus on morphology and ancillary testing of mainly pleural mesothelial proliferations.
This paper references
Pleomorphic Epithelioid Diffuse Malignant Pleural Mesothelioma: A Clinicopathological Review and Conceptual Proposal to Reclassify as Biphasic or Sarcomatoid Mesothelioma
Kyuichi Kadota (2011)
SYT-SSX fusion is absent in sarcomatoid mesothelioma allowing its distinction from synovial sarcoma of the pleura
N. Weinbreck (2007)
Homozygous deletion of CDKN2A and codeletion of the methylthioadenosine phosphorylase gene in the majority of pleural mesotheliomas.
P. Illei (2003)
Diagnostic usefulness of EMA, IMP3, and GLUT‐1 for the immunocytochemical distinction of malignant cells from reactive mesothelial cells in effusion cytology using cytospin preparations
K. Ikeda (2011)
Sarcomatoid mesothelioma: a clinical–pathologic correlation of 326 cases
S. Klebe (2010)
BAP1 Immunohistochemistry and p16 FISH to Separate Benign From Malignant Mesothelial Proliferations
B. Sheffield (2015)
Mesothelial tumors-diffuse malignant mesothelioma
F Galateau-Salle (2015)
Deletion status of p16 in effusion smear preparation correlates with that of underlying malignant pleural mesothelioma tissue
T. Hida (2015)
Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed‐Type Malignant Mesothelioma: a secondary publication
A. Hjerpe (2015)
Sarcomatoid neoplasms of the lung and pleura.
W. Travis (2010)
Alterations of the p16(INK4) locus in human malignant mesothelial tumors.
T. Hirao (2002)
A nuclear grading system is a strong predictor of survival in epitheloid diffuse malignant pleural mesothelioma
Kyuichi Kadota (2012)
p16 Deletion in sarcomatoid tumors of the lung and pleura.
N. Tochigi (2013)
Fluorescence in situ hybridization in the definitive diagnosis of malignant mesothelioma in effusion cytology.
S. Savic (2010)
BAP1 facilitates diagnostic objectivity, classification, and prognostication in malignant pleural mesothelioma.
Stephanie M. McGregor (2015)
Comprehensive genomic analysis of malignant pleural mesothelioma identifies recurrent mutations, gene fusions and splicing alterations
R. Bueno (2016)
Germline BAP1 mutations predispose to malignant mesothelioma
J. Testa (2011)
Diagnostic importance of 9p21 homozygous deletion in malignant mesotheliomas
S. Chiosea (2008)
Frequent inactivation of the BAP1 gene in epithelioid‐type malignant mesothelioma
Yoshie Yoshikawa (2012)
Challenges and controversies in the diagnosis of mesothelioma: Part 1. Cytology-only diagnosis, biopsies, immunohistochemistry, discrimination between mesothelioma and reactive mesothelial hyperplasia, and biomarkers
D. Henderson (2013)
Morphology of 9p21 homozygous deletion‐positive pleural mesothelioma cells analyzed using fluorescence in situ hybridization and virtual microscope system in effusion cytology
S. Matsumoto (2013)
The diagnostic utility of p16 FISH and GLUT-1 immunohistochemical analysis in mesothelial proliferations.
S. Monaco (2011)
The diagnosis of malignant mesothelioma in effusion cytology
A. Paintal (2013)
A recurrent germline BAP1 mutation and extension of the BAP1 tumor predisposition spectrum to include basal cell carcinoma
K.A.W. Wadt (2015)
Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial
N. Maskell (2003)
Introduction to The 2015 World Health Organization Classification of Tumors of the Lung, Pleura, Thymus, and Heart.
W. Travis (2015)
The Separation of Benign and Malignant Mesothelial Proliferations
A. Churg (2012)
BAP1 Immunostain and CDKN2A (p16) FISH Analysis
A. Walts (2016)
The immunohistochemical characterization of sarcomatoid malignant mesothelioma of the pleura.
L. Chirieac (2011)
CDKN2A and MTAP deletions in peritoneal mesotheliomas are correlated with loss of p16 protein expression and poor survival
A. Krasinskas (2010)
Clinical Characteristics of Patients with Malignant Pleural Mesothelioma Harboring Somatic BAP1 Mutations
M. Zauderer (2013)
Parakeratotic-like cells in effusions — A clue to diagnosis of malignant mesothelioma
L. Gao (2012)
A grading system combining architectural features and mitotic count predicts recurrence in stage I lung adenocarcinoma
Kyuichi Kadota (2012)
CT Scan-Guided Abrams' Needle Pleural Biopsy versus Ultrasound-Assisted Cutting Needle Pleural Biopsy for Diagnosis in Patients with Pleural Effusion: A Randomized, Controlled Trial
M. Metintas (2016)
New Markers for Separating Benign From Malignant Mesothelial Proliferations: Are We There Yet?
A. Churg (2016)
Guidelines for pathologic diagnosis of malignant mesothelioma: 2012 update of the consensus statement from the International Mesothelioma Interest Group.
A. Husain (2013)
Accuracy of Diagnostic Biopsy for the Histological Subtype of Malignant Pleural Mesothelioma
S. Kao (2011)
Global gene expression profiling of pleural mesotheliomas: overexpression of aurora kinases and P16/CDKN2A deletion as prognostic factors and critical evaluation of microarray-based prognostic prediction.
Fernando López-Ríos (2006)
Use of p16 FISH for differential diagnosis of mesothelioma in smear preparations
K. Nabeshima (2016)
Fine needle aspiration cytology of malignant mesothelioma.
G. Sterrett (1987)
Malignant mesothelioma with heterologous elements: clinicopathological correlation of 27 cases and literature review
S. Klebe (2008)
Diagnostic usefulness of p16/CDKN2A FISH in distinguishing between sarcomatoid mesothelioma and fibrous pleuritis.
D. Wu (2013)
Utility of BAP1 Immunohistochemistry and p16 (CDKN2A) FISH in the Diagnosis of Malignant Mesothelioma in Effusion Cytology Specimens
H. Hwang (2016)
Whole-exome sequencing reveals frequent genetic alterations in BAP1, NF2, CDKN2A, and CUL1 in malignant pleural mesothelioma.
Guangwu Guo (2015)
Oncofetal Protein IMP3, a New Diagnostic Biomarker to Distinguish Malignant Mesothelioma From Reactive Mesothelial Proliferation
M. Shi (2011)
Pleomorphic mesothelioma: report of 10 cases
N. Ordóñez (2012)
The use of immunohistochemistry in distinguishing reactive from neoplastic mesothelium. A novel use for desmin and comparative evaluation with epithelial membrane antigen, p53, platelet‐derived growth factor‐receptor, P‐glycoprotein and Bcl‐2
R. Attanoos (2003)

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Biomarkers in the diagnosis and treatment of malignant pleural disease: an integrative review
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The "Brescia panel" (Claudin-4 and BRCA-associated protein 1) in the differential diagnosis of mesotheliomas with epithelioid features versus metastatic carcinomas.
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Homozygous deletion of CDKN2A in malignant mesothelioma: Diagnostic utility, patient characteristics and survival in a UK mesothelioma centre.
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Pathologic considerations and standardization in mesothelioma clinical trials.
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Optimal diagnosis and treatment of malignant pleual disease: challenging the guidelines
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