reactive mesothelial hyperplasia
Wednesday 26 September 2012
in a hernia sac (WebPathology)
Yet despite the advent of immunohistochemistry as an essential adjunct to the pathological diagnosis of MM, consistent and reliable diagnosis continues to be problematical in some cases, especially for small biopsies.
Many anatomical pathologists emphasise the identiﬁcation of neoplastic invasion as the deﬁnitive criterion for deﬁnitive diagnosis of malignant mesothelioma as opposed to reactive mesothelial hyperplasia.
Accordingly, Churg and Galateau-Sallé stated in 2012 that, after allowance for pseudoinvasive ﬁndings such as en face sections and benign entrapment of mesothelioma as a consequence of ﬁbro-inﬂammatory processes: ‘… invasion of the stroma continues to be by far the most reliable criterion for separating benign from malignant mesothelial proliferations. Fat is the stroma most frequently encountered and the ﬁnding of mesothelial cells in fat makes the proliferation malignant unless there is an extraordinarily good reason to believe otherwise. The same comment applies [even more so] to invasion of muscle or invasion of lung or another organ.’