Skip to main content

Epithelioid mesothelioma

Distinction between epithelioid mesothelioma and adenocarcinoma has been, and re- mains, the subject of numerous publications dating back over several decades. The current approach, using histochemistry and immunohistochemical panels, facilitates the diagnosis in the vast majority of cases, although there is a subset of difficult cases, in which ultrastructural assessment may still be required.

Controversy remains as to which immunohistochemical markers are of greatest value although there is general acceptance that distinction between mesothelioma and adenocarcinoma requires the use of a panel of antibodies rather than reliance on a single immunohistochemical result. The component antibodies included in these panels are undergoing change, with the recent commercial availability of several novel antibodies positive in mesothelioma.

Effusion cytology

Approximately 60% of mesotheliomas can be diagnosed on morphological grounds in effusion specimens; 20% require additional ancillary studies (immunohistochemistryor EM) and 20% are undiagnosable by cytology, either due to inadequacy of the sample or the poorly differentiated nature of the tumour. We advocate the routine use of ancillary immunohistochemical studies in all cases.

Histology

Distinguishing between mesothelioma and adenocarcinoma in biopsy specimens presents similar problems to those encountered in cytological specimens. Often, the morphological clues present in a cytology specimen are not as easily recognised in biopsy material, particularly in small or distorted samples. The diagnostic sensitivity of a small biopsy is less than that of an effusion specimen, as the latter reflects cell shedding from a total serosal surface bathed in fluid. Classical features of well differentiated epithelial mesothelioma in biopsy material include tubulo-papillary or tubular configurations; papillary formations with connective tissue cores may project into large tubular structures. A microcystic architecture is sometimes present. Psammoma bodies are present in 5–10% of cases and represent a non-specific finding. The lining cells are usually cuboidal, and, as in effusion samples, the presence of cells with a columnar morphology is more suggestive of adenocarcinoma. Nuclei are often very bland. Less differentiated tumours may consist partly or wholly of sheets of cells without tubular or papillary patterns. These cells may show lack of cohesion, another useful discriminant from adenocarcinoma.

MESOTHELIOMA CANSER INFO

Labels:

Comments

Post a Comment

Popular posts from this blog

The mesothelial cell

The mesothelial cells line the serosal cavities of the body, the pleural, peritoneal and pericardial spaces. Geographically, across the serosal surfaces, mesothelial cells canbe seen to have a variety of morphologies between flat or cuboidal and showing few or a dense forest of microvilli. Although their important in vivo functions have not been identified, they have the potential to regulate cell traffic, the balance between coagulation and fibrinolysis, cell proliferation, and fibrogenesis within and around the pleural space. They likely represent the progenitor cell for mesothelioma. In in vitro studies, the mesothelial cell demonstrates a multitude of abilities. Mesothelial cells can produce most of the components of the submesothelial matrix, at amounts comparable to that of fibroblasts. They can also release growth factors such as TGF-beta and insulin-like growth factorI. The cells may regulate the fibrinolytic and procoagulant activities on their cell surface and in the pleural ...
Post a Comment
Read more

Novel Molecular, Epidemiological, and Therapeutic Issues in Mesothelioma: The Role of SV40

The rise in mesothelioma cases that has occurred since 1950 has been associated with the widespread commercial use of asbestos. However, less than 10% of asbestos workers exposed to high levels of asbestos actually develop the disease, suggesting that additional factors may increase an individual’s susceptibility to the carcinogenic effects of asbestos. In addition, about 20% of mesotheliomas are not associated with asbestos exposure, suggesting that alternative factors may also cause mesothelioma. * The SV40 SV40 is a DNA tumour virus which was introduced into a significant portion of the human population between 1955 and 1963 through polio vaccines and adenovaccines contaminated with the virus. SV40 and human tumours The discovery that SV40 produced tumours in hamsters led to the PCR analysis of human mesotheliomas for the presence of SV40. Our group was the first to investigate whether there was any correlation between Polyomavirus and mesothelioma, and this was accom- plished in tw...
Post a Comment
Read more

Mesothelioma Article: FREE DOWNLOAD

M alignant mesothelioma is a 20th century phenomenon and as we begin a new century it is timely to review the clinical, research, epidemiological and legal aspects of this disease. I t is a canser, and canser is " a slang or slang-like term for any malignant growth or tumor caused by abnormal and uncontrolled cell division". Cancer affects people at all ages with the risk for most types increasing with age. Cancer caused about 13% of all human deaths in 2007 (7.6 million). T umor is derived, via the Old French tumour , from the Latin tumor "swelling". It originally meant an abnormal swelling of the flesh. In contemporary English, tumor is synonymous with solid neoplasm. A tumor may be benign, pre-malignant or malignant. The nature of the tumor is determined by a pathologist after examination of the tumor tissues from a biopsy or a surgical excision specimen. T he epidemic of mesothelioma has been seen throughout the world, not just in Australia. In Europe mesot...
Post a Comment
Read more