Pleural diffuse mesothelial lesions: A challenge for pathologists
Abstract
Malignant mesothelioma (MM) is a highly aggressive tumor deriving from the mesothelial cells normally lining the body cavities. Histologically, MM is classified in three major histopathological patterns, such as epithelioid, sarcomatoid and mixed type. It is well known that the diagnosis of MM can be very challenging, especially in small bioptic fragments or cytological specimens.
The most common diagnostic pitfalls involve the distinction between primary epithelioid MM and metastatic adenocarcinoma as well as that between reactive epithelial/fibrous benign proliferations and MM. Recently, a pathologist’s panel suggested new practical strategies and recommendations for the MM diagnosis, regarding the interpretation of histo-cytological features and the composition of appropriate immunohistochemical algorithm. Finally, according to the updated international guidelines, morphological data require a careful clinico-pathological correlation to achieve an accurate diagnosis of pleural lesions.
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1. Bruno, R., Alì, G., Fontanini, G., (2018) Molecular markers and new diagnostic methods to differentiate malignant from benign mesothelial pleural proliferations: a literature review. J Thorac Dis. 10:S342-S352.
2. Angelico, G., Ieni, A., Tuccari, G., (2018) Immunohistochemical Diagnostic Approach in Neoplastic Pathology of Mesothelium. Clin Oncol Res. 1: 1001.
3. Angelico, G., Ieni, A., Caltabiano, R., Spadola, S., Giuffrè, G., Tuccari, G., (2017) Immunohistochemical evidence of Aquaporin 1 (AQP1) in Fluoroedenite-induced mesotheliomas: a preliminary report. APMB. 105:A10
4. Alì, G., Bruno, R., Fontanini, G.,(2018) The pathological and molecular diagnosis of malignant pleural mesothelioma: a literature review. J Thorac Dis. 10:S276-S284.
5. Marchevsky, A.M., LeStang, N., Hiroshima, K., Pelosi, G., Attanoos, R., Churg, A., Chirieac, L., Dacic, S., Husain, A., Khoor, A., Klebe, S., Lantuejoul, S., Roggli, V., Vignaud, J.M., Weynard, B., Sauter, J., Henderson, D., Nabeshima, K., Galateau-Salle, F., (2017) The differential diagnosis between pleural sarcomatoid mesothelioma and spindle cell/pleomorphic (sarcomatoid) carcinomas of the lung: evidence-based guidelines from the International Mesothelioma Panel and the MESOPATH National Reference Center. Hum Pathol. 67:160-168.
6. Angelico, G., Ieni, A., Tuccari, G., (2018) The Diagnostic Immunohistochemistry of Mesothelium and Its Related Neoplastic Conditions. In Diagnostic Immunohistochemistry, Avid Science e-book, chapter 1, 2-29.
7. Pereira, T.C., Saad, R.S., Liu, Y., Silverman, J.F., (2006) The diagnosis of malignancy in effusion cytology: a pattern recognition approach. Adv Anat Pathol. 13:174-84.
8. Novello, S., Pinto, C., Torri, V., Porcu, L., Di Maio, M., Tiseo, M., Ceresoli, G., Magnani, C., Silvestri, S., Veltri, A., Papotti, M., Rossi, G., Ricardi, U., Trodella, L., Rea, F., Facciolo, F., Granieri, A., Zagonel, V., Scagliotti, G., (2016) The Third Italian Consensus Conference for Malignant Pleural Mesothelioma: State of the art and recommendations. Crit Rev Oncol Hematol. 104:9-20
9. Galateau-Salle, F., Churg, A., Roggli, V., Travis, W.D., World Health Organization Committee for Tumors of the Pleura., (2016) The 2015 World Health Organization Classification of Tumors of the Pleura: Advances since the 2004 Classification. J Thorac Oncol. 11:142-54.
10. Miyoshi, S., Sasada, S., Izumo, T., Matsumoto, Y., Tsuchida, T. (2016) Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis. PLoS One. 11:e0167186.
11. Hjerpe, A., Ascoli, V., Bedrossian, C., Boon, M., Creaney, J., Davidson, B., Dejmek, A., Dobra, K., Fassina, A., Field, A., Firat, P., Kamei, T., Kobayashi, T., Michael, C.W., Önder, S., Segal, A., Vielh, P., (2015) Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology. Cytojournal. 30;12:26
12. Husain, A.N., Colby, T., Ordonez, N., Krausz, T., Attanoos, R., Beasley, M.B., Borczuk, A.C., Butnor, K., Cagle, P.T., Chirieac, L.R., Churg, A., Dacic, S., Fraire, A. , Galateau-Salle, F., Gibbs, A., Gown, A., Hammar, S., Litzky, L., Marchevsky, A.M., Nicholson, A.G., Roggli, V., Travis, W.D., Wick, M., ( 2013) Guidelines for pathologic diagnosis of malignant mesothelioma: 2012 update of the consensus statement from the International Mesothelioma Interest Group. International Mesothelioma Interest Group. Arch Pathol Lab Med. 137:647-67.
13. Husain, A.N., Colby, T., Ordonez, N., Krausz, T., Borczuk, A.C., Cagle, P.T., Chirieac, L.R., Churg, A., Galateau-Salle, F., Gibbs, A., Gown, A., Hammar, S., Litzky, L., A.G., Roggli, V., Travis, W.D., Wick, M. R., (2009) Guidelines for pathologic diagnosis of malignant mesothelioma: a consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med. 133:1317-31
14. Arif, Q., Husain, A.N., (2015) Malignant Mesothelioma Diagnosis. Arch Pathol Lab Med. 139:978-80.
15. Betta, P.G., Magnani, C., Bensi, T., Trincheri, N.F., Orecchia, S., (2012) Immunohistochemistry and molecular diagnostics of pleural malignant mesothelioma. Arch Pathol Lab Med. 136:253-61.
16. Bedrossian, C.W., (2015) An update on pleuro-pulmonary cytopathology: Part i: Cytological diagnosis of mesothelioma and molecular cytology of lung cancer with an historical perspective. Diagn Cytopathol. 43:513-26.
17. Henderson, D.W., Reid, G., Kao, S.C., van Zandwijk, N., Klebe, S., (2013) Challenges and controversies in the diagnosis of mesothelioma: Part 1. Cytology-only diagnosis, biopsies, immunohistochemistry, discrimination between mesothelioma and reactive mesothelial hyperplasia, and biomarkers. J Clin Pathol. 66:847-53.
18. Henderson, D.W., Reid, G., Kao, S.C., van Zandwijk, N., Klebe, S., (2013) Challenges and controversies in the diagnosis of malignant mesothelioma: Part 2. Malignant mesothelioma subtypes, pleural synovial sarcoma, molecular and prognostic aspects of mesothelioma, BAP1, aquaporin-1 and microRNA. J Clin Pathol. 66:854-61.
19. Walters, J., Maskell, N.A., (2011) Biopsy techniques for the diagnosis of mesothelioma. Recent Results Cancer Res. 189:45-55.
20. Kao, S.C., Reid, G., van Zandwijk, N., Henderson, D.W., Klebe, S., (2011) Molecular biomarkers in malignant mesothelioma: state of the art. Pathology. 43:201-12.
Zeren, E.H., Demirag, F., (2010) Benign and Malignant Mesothelial Proliferation. Surg Pathol Clin. 3:83-107.
21. Addis, B., Roche, H., (2009) Problems in mesothelioma diagnosis. Histopathology. 54:55-68.
Suster, S., Moran, C.A., (2006) Applications and limitations of immunohistochemistry in the diagnosis of malignant mesothelioma. Adv Anat Pathol. 13:316-29.
22. Habougit, C., Trombert-Paviot, B., Karpathiou, G., Casteillo, F., Bayle-Bleuez, S., Fournel, P., Vergnon, J.M., Tiffet, O., Péoc'h, M., Forest, F., (2017) Histopathologic features predict survival in diffuse pleural malignant mesothelioma on pleural biopsies. Virchows Arch. 470:639-646
23. Monaco, S., Mehrad, M., Dacic, S., (2018) Recent Advances in the Diagnosis of Malignant Mesothelioma: Focus on Approach in Challenging Cases and in Limited Tissue and Cytologic Samples. Adv Anat Pathol. 25:24-30.
24. Husain, A.N., Colby, T., Ordonez, N., Allen, T.C., Attanoos, R.L., Beasley, M.B., Butnor, K.J., Chirieac, L.R., Churg, A., Dacic, S., Galateau-Salle, F., Gibbs, A., Gown, A., Krausz, T., Litzky, L.A., Marchevsky, A., Nicholson, A.G., Roggli, V.L., Sharma, A.K., Travis, W.D., Walts, A.E.,Wick, M. R., (2018) Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group. Arch Pathol Lab Med. 142:89-108.
25. Ascoli, V., (2015) Pathologic diagnosis of malignant mesothelioma: chronological prospect and advent of recommendations and guidelines. Ann Ist Super Sanita. 51:52-9.
26. Righi, L., Duregon, E., Vatrano, S., Izzo, S., Giorcelli, J., Rondón-Lagos, M., Ascoli, V., Ruffini, E., Ventura, L., Volante, M., Papotti, M., Scagliotti, G.V., (2016) BRCA1-Associated Protein 1 (BAP1) Immunohistochemical Expression as a Diagnostic Tool in Malignant Pleural Mesothelioma Classification: A Large Retrospective Study. J Thorac Oncol. 11:2006-2017.
27. Nabeshima, K., Matsumoto, S., Hamasaki, M., Hida, T., Kamei, T., Hiroshima, K., Tsujimura, T., Kawahara, K., (2016) Use of p16 FISH for differential diagnosis of mesothelioma in smear preparations. Diagn Cytopathol. 44:774-80.
28. Hwang, H.C., Pyott, S., Rodriguez, S., Cindric, A., Carr, A., Michelsen, C., Thompson, K., Tse, C.H., Gown. A.M., Churg. A., (2016) BAP1 Immunohistochemistry and p16 FISH in the Diagnosis of Sarcomatous and Desmoplastic Mesotheliomas. Am J Surg Pathol. 40:714-8.
McGregor, S.M., McElherne, J., Minor, A., Keller-Ramey, J., Dunning, R., Husain, A.N., Vigneswaran, W., Fitzpatrick, C., Krausz, T., (2017) BAP1 immunohistochemistry has limited prognostic utility as a complement of CDKN2A (p16) fluorescence in situ hybridization in malignant pleural mesothelioma. Hum Pathol. 60:86-94
DOI: https://doi.org/10.6092/1828-6550/APMB.106.1.2018.SD2
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Copyright (c) 2018 Antonio Ieni, Francesco Arena, Giuseppe Angelico, Giovanni Tuccari
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