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Vol.57 No.4 contents | Japanese/English |
 | Full Text of PDF (4215K) Article in Japanese |
- Invited Review Article -
Mesothelioma: a Review and Update
Kenzo Hiroshima11Tokyo Women's Medical University Yachiyo Medical Center, Japan
The pathological diagnosis of mesothelioma is difficult because some neoplasms and benign mesothelial proliferation show similar pathological findings to mesothelioma. Lung carcinomas can be pathologically diagnosed with small biopsies, but the small samples obtained on a biopsy are sometimes not enough for a definitive diagnosis of mesothelioma. Thoracoscopy with general anesthesia is now the preferred method of obtaining sufficient material to make a pathological diagnosis of early-stage mesothelioma. Malignant mesothelioma is classified into epithelioid, sarcomatoid, and biphasic mesothelioma. It is important to use panels of positive and negative antibodies for the diagnosis of epithelioid and biphasic mesothelioma. However, mesothelial markers are often negative or only focally positive in sarcomatoid mesothelioma. Cytokeratin should be used for the diagnosis of sarcomatoid mesothelioma, and true sarcomas and sarcomatoid carcinomas should be ruled out. The separation of benign from malignant mesothelial proliferations is a major problem in the pathology of early-stage mesothelioma. BAP1 immunohistochemistry and p16 FISH help differentiate malignant tumors from benign mesothelial proliferations. Patients with early-stage pleural mesothelioma often have pleural effusion. Mesothelioma can be diagnosed based on the examination of the effusion using cell blocks with immunohistochemical and FISH analyses. Pathologists should take the clinical, radiologic, and pathologic features into consideration when making a diagnosis.
key words: Mesothelioma, Immunohistochemistry, FISH, p16, BAP1
JJLC 57 (4): 259-271, 2017
