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Difference between revisions of "Malignant mesothelioma"
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Malignant mesothelioma (view source)
Revision as of 19:53, 18 December 2024
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| LMDDx = mesothelial hyperplasia, [[fibrosing pleuritis]], [[adenocarcinoma]] - esp. [[lung adenocarcinoma|lung]], [[serous carcinoma]] | | LMDDx = mesothelial hyperplasia, [[fibrosing pleuritis]], [[adenocarcinoma]] - esp. [[lung adenocarcinoma|lung]], [[serous carcinoma]] | ||
| Stains = | | Stains = | ||
| IHC = calretinin +ve, D2-40 +ve, [[CK5/6]] +ve, WT-1 +ve, [[CK7]] +ve, CEA -ve, [[TTF-1]] -ve | | IHC = calretinin +ve, D2-40 +ve, [[CK5/6]] +ve, WT-1 +ve, [[CK7]] +ve, CEA -ve, [[TTF-1]] -ve, MTAP -ve (pleural mesothelioma), BAP1 -ve | ||
| EM = | | EM = | ||
| Molecular = +/-p16 deletion | | Molecular = +/-p16 deletion | ||
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DDx:<ref name=pmid15559051>{{Cite journal | last1 = Corson | first1 = JM. | title = Pathology of mesothelioma. | journal = Thorac Surg Clin | volume = 14 | issue = 4 | pages = 447-60 | month = Nov | year = 2004 | doi = 10.1016/j.thorsurg.2004.06.007 | PMID = 15559051 }} | DDx:<ref name=pmid15559051>{{Cite journal | last1 = Corson | first1 = JM. | title = Pathology of mesothelioma. | journal = Thorac Surg Clin | volume = 14 | issue = 4 | pages = 447-60 | month = Nov | year = 2004 | doi = 10.1016/j.thorsurg.2004.06.007 | PMID = 15559051 }} | ||
</ref> | </ref> | ||
<ref name="pmid15725802">{{Cite journal | last1 = Bégueret | first1 = H. | last2 = Galateau-Salle | first2 = F. | last3 = Guillou | first3 = L. | last4 = Chetaille | first4 = B. | last5 = Brambilla | first5 = E. | last6 = Vignaud | first6 = JM. | last7 = Terrier | first7 = P. | last8 = Groussard | first8 = O. | last9 = Coindre | first9 = JM. | title = Primary intrathoracic synovial sarcoma: a clinicopathologic study of 40 t(X;18)-positive cases from the French Sarcoma Group and the Mesopath Group. | journal = Am J Surg Pathol | volume = 29 | issue = 3 | pages = 339-46 | month = Mar | year = 2005 | doi = | PMID = 15725802 }}</ref> | |||
*[[Fibrosing pleuritis]] - should ''not'' have nodules, more cellular on the aspect adjacent to the effusion. | *[[Fibrosing pleuritis]] - should ''not'' have nodules, more cellular on the aspect adjacent to the effusion. | ||
*Reactive mesothelial cells - may be atypical. | *Reactive mesothelial cells - may be atypical. | ||
| Line 85: | Line 86: | ||
*[[Adenocarcinoma]] - esp. [[lung adenocarcinoma]]. | *[[Adenocarcinoma]] - esp. [[lung adenocarcinoma]]. | ||
*[[Serous carcinoma]]. | *[[Serous carcinoma]]. | ||
*[[Synovial sarcoma]]. | |||
===Images=== | ===Images=== | ||
| Line 96: | Line 98: | ||
Image: Malignant epithelioid mesothelioma - calretinin - high mag.jpg | MM - calretinin - high mag. | Image: Malignant epithelioid mesothelioma - calretinin - high mag.jpg | MM - calretinin - high mag. | ||
</gallery> | </gallery> | ||
====www==== | |||
*[http://www.rosaicollection.org/searchresults.cfm/ Mesothelioma (rosaicollection.org/index.cfm)]. | |||
===Subtypes=== | ===Subtypes=== | ||
| Line 118: | Line 123: | ||
*EMA +ve ~100% (vs. ~10%). | *EMA +ve ~100% (vs. ~10%). | ||
*Desmin -ve ~5% (vs. ~85%). | *Desmin -ve ~5% (vs. ~85%). | ||
*GLUT1 +ve ~50% (vs. ~10%) | *GLUT1 +ve ~50% (vs. ~10%). | ||
*p53 +ve ~50% (vs. ~2%). | *p53 +ve ~50% (vs. ~2%). | ||
*BAP1 -ve<ref name=pmid29085180>{{cite journal |authors=Pulford E, Huilgol K, Moffat D, Henderson DW, Klebe S |title=Malignant Mesothelioma, BAP1 Immunohistochemistry, and VEGFA: Does BAP1 Have Potential for Early Diagnosis and Assessment of Prognosis? |journal=Dis Markers |volume=2017 |issue= |pages=1310478 |date=2017 |pmid=29085180 |pmc=5612603 |doi=10.1155/2017/1310478 |url=}}</ref> ~57%.<ref name=pmid26226841>{{cite journal |authors=Andrici J, Sheen A, Sioson L, Wardell K, Clarkson A, Watson N, Ahadi MS, Farzin M, Toon CW, Gill AJ |title=Loss of expression of BAP1 is a useful adjunct, which strongly supports the diagnosis of mesothelioma in effusion cytology |journal=Mod Pathol |volume=28 |issue=10 |pages=1360–8 |date=October 2015 |pmid=26226841 |pmc=4761613 |doi=10.1038/modpathol.2015.87 |url=}}</ref> | |||
Note: | Note: | ||
*The above are ''not'' very useful in individual cases. | *The above are ''not'' very useful in individual cases. | ||
*A simple pankeratin is useful for seening where epithelial cells are. | *A simple pankeratin is useful for seening where epithelial cells are. | ||
Others: | |||
*MTAP -ve.<ref name=pmid34465883>{{cite journal |authors=Dacic S |title=Pleural mesothelioma classification-update and challenges |journal=Mod Pathol |volume=35 |issue=Suppl 1 |pages=51–56 |date=January 2022 |pmid=34465883 |doi=10.1038/s41379-021-00895-7 |url=}}</ref> | |||
**May not be sensitive and specific for peritoneal mesothelioma.{{fact}} | |||
===Mesothelioma versus adenocarcinoma=== | ===Mesothelioma versus adenocarcinoma=== | ||
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**D2-40. | **D2-40. | ||
**[[CK5/6]]. | **[[CK5/6]]. | ||
**[[CA-125]].<ref name=pmid9023557>{{cite journal |authors=Bateman AC, al-Talib RK, Newman T, Williams JH, Herbert A |title=Immunohistochemical phenotype of malignant mesothelioma: predictive value of CA125 and HBME-1 expression |journal=Histopathology |volume=30 |issue=1 |pages=49–56 |date=January 1997 |pmid=9023557 |doi=10.1046/j.1365-2559.1996.d01-562.x |url=}}</ref> | |||
*Carcinoma markers: | *Carcinoma markers: | ||
**CEA (monoclonal and polyclonal). | **CEA (monoclonal and polyclonal). | ||
**[[TTF-1]]. | **[[TTF-1]]. | ||
**[[Ber-EP4]]. | **[[Ber-EP4]]. | ||
***100% of lung adenocarcinoma versus ~25% of mesotheliomas.<ref>{{cite journal |authors=Ordóñez NG |title=Value of the Ber-EP4 antibody in differentiating epithelial pleural mesothelioma from adenocarcinoma. The M.D. Anderson experience and a critical review of the literature |journal=Am J Clin Pathol |volume=109 |issue=1 |pages=85–9 |date=January 1998 |pmid= |doi=10.1093/ajcp/109.1.85 |url=}}</ref> | |||
**MOC-31. | **MOC-31. | ||
**CD15. | **CD15. | ||
**[[B72.3]]. | |||
===Other carcinoma markers=== | ===Other carcinoma markers=== | ||