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pleural mesothelioma - Humpath.com - Human pathology

Home > E. Pathology by systems > Respiratory system > Pleura > pleural mesothelioma

pleural mesothelioma

Wednesday 26 September 2012

pleural mesothelial neoplasia

Digital cases

- epithelial mesothelioma

- 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)

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