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Parra-Medina R, Castañeda-González JP, Chaves-Cabezas V, Alzate JP, Chaves JJ. Diagnostic performance of immunohistochemistry markers for malignant pleural mesothelioma diagnosis and subtypes. A systematic review and meta-analysis. Pathol Res Pract 2024; 257:155276. [PMID: 38603842 DOI: 10.1016/j.prp.2024.155276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) poses diagnostic challenges due to its resemblance to benign pleural pathologies and different histological subtypes. Several immunohistochemistry markers have been employed to aid in accurate diagnosis. METHODS The present systematic review and meta-analysis aimed to assess the diagnostic performance of various immunohistochemistry markers in malignant pleural mesothelioma diagnosis and its histological subtypes. Following the PRISMA guidelines, we systematically searched the literature for articles on using different immunohistochemical markers in MPM and its histological subtypes. EMBASE, LILACS, MEDLINE, and Virtual Health Library were searched for studies published up to August 2023. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria to assess the quality of the included articles. Meta-analyses were performed to determine prevalence using a random-effects model. RESULTS 103 studies met the inclusion criteria, comprising a diverse range of immunohistochemistry markers. EMA and desmin-loss exhibited high sensitivity (96% and 92%, respectively) in distinguishing malignant pleural mesothelioma from benign pleural pathologies. Specificity was notably high for both BAP1-loss and survivin expression at 100%. Subtype-specific analyses demonstrated that EMA and HEG1 were sensitive markers for epithelioid mesothelioma, while GLUT1 showed high sensitivity for sarcomatoid mesothelioma. In cases comparing epithelioid mesothelioma and lung adenocarcinoma, CAM5.2 and calretinin displayed high sensitivity, while WT1 and BAP1-loss demonstrated exceptional specificity for malignant epithelioid mesothelioma. In the case of sarcomatoid mesothelioma and sarcomatoid lung carcinoma, GATA3 exhibited the most heightened sensitivity, while GATA3 and D2-40 displayed the best specificity for sarcomatoid malignant mesothelioma diagnosis. CONCLUSION Immunohistochemistry markers are essential in accurately diagnosing malignant pleural mesothelioma and its histological subtypes. This systematic review and meta-analysis provide a comprehensive insight into the diagnostic performance of these markers, facilitating their potential clinical utility in the discrimination of malignant pleural mesothelioma from other pleural pathologies and the differentiation of malignant pleural mesothelioma subtypes.
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Affiliation(s)
- Rafael Parra-Medina
- Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia; Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia; Department of Pathology, Instituto Nacional de Cancerología, Bogotá.
| | - Juan Pablo Castañeda-González
- Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia; Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
| | - Viviana Chaves-Cabezas
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
| | - Juan Pablo Alzate
- Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.
| | - Juan José Chaves
- Department of Medicine, Norwalk Hospital, Yale School of Medicine, Norwalk, CT, United States.
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Khalifa S, Khairy R, Khaled E, El Sheikh S, Abdlaziz A. Utility of a highly specific and sensitive podoplanin/D2-40, calretinin, thyroid transcription factor-1, and carcinoembryonic antigen/CD66e immunohistochemical panel in differentiating malignant pleural mesothelioma from metastatic adenocarcinoma: An Egyptian experience. J Microsc Ultrastruct 2022. [DOI: 10.4103/jmau.jmau_51_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mishra S, Taelman J, Chang YW, Boel A, De Sutter P, Heindryckx B, Chuva De Sousa Lopes SM. Sex-Specific Isolation and Propagation of Human Premeiotic Fetal Germ Cells and Germ Cell-Like Cells. Cells 2021; 10:cells10051214. [PMID: 34065661 PMCID: PMC8156680 DOI: 10.3390/cells10051214] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/08/2021] [Accepted: 05/13/2021] [Indexed: 12/15/2022] Open
Abstract
The second trimester of human development is marked by asynchronous gonadal development hampering the isolation of homogenous populations of early and late fetal germ cells (FGCs). We evaluated the feasibility of using surface markers TNAP, PDPN, EPCAM and ITGA6 to isolate FGCs as well as human primordial germ cell-like cells (hPGCLCs) derived from embryonic stem cells (hESCs) from both sexes by fluorescence-activated cell sorting (FACS). Our results suggest that a combination of TNAP and PDPN was sufficient to separate populations of premeiotic FGCs and hPGCLCs in both sexes. This combination of antibodies also proved efficient in separating 'mitotic' from 'retinoic-acid responsive' female FGCs. Furthermore, we report that the differentiation efficiency of TNAP+PDPN+ hPGCLCs from hESCs was sex-independent, but the ability to propagate differed considerably between the sexes. In contrast to male, female hPGCLCs retained their characteristics and exhibited robust colony-forming ability when cultured for five days in medium containing LIF, forskolin and FGF2. We conclude that marked sex differences exist in the isolation and propagation of human FGCs and hPGCLCs. Our study provides novel insights relevant for the optimization of in vitro gametogenesis in humans.
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Affiliation(s)
- Swati Mishra
- Ghent-Fertility and Stem Cell Team (G-FaST), Department for Reproductive Medicine, Ghent University Hospital, 9000 Ghent, Belgium; (S.M.); (J.T.); (A.B.); (P.D.S.)
| | - Jasin Taelman
- Ghent-Fertility and Stem Cell Team (G-FaST), Department for Reproductive Medicine, Ghent University Hospital, 9000 Ghent, Belgium; (S.M.); (J.T.); (A.B.); (P.D.S.)
| | - Yolanda W. Chang
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands;
| | - Annekatrien Boel
- Ghent-Fertility and Stem Cell Team (G-FaST), Department for Reproductive Medicine, Ghent University Hospital, 9000 Ghent, Belgium; (S.M.); (J.T.); (A.B.); (P.D.S.)
| | - Petra De Sutter
- Ghent-Fertility and Stem Cell Team (G-FaST), Department for Reproductive Medicine, Ghent University Hospital, 9000 Ghent, Belgium; (S.M.); (J.T.); (A.B.); (P.D.S.)
| | - Björn Heindryckx
- Ghent-Fertility and Stem Cell Team (G-FaST), Department for Reproductive Medicine, Ghent University Hospital, 9000 Ghent, Belgium; (S.M.); (J.T.); (A.B.); (P.D.S.)
- Correspondence: (B.H.); (S.M.C.D.S.L.); Tel.: +32-9332-4748 (B.H.); +31-71-526-9350 (S.M.C.D.S.L.)
| | - Susana M. Chuva De Sousa Lopes
- Ghent-Fertility and Stem Cell Team (G-FaST), Department for Reproductive Medicine, Ghent University Hospital, 9000 Ghent, Belgium; (S.M.); (J.T.); (A.B.); (P.D.S.)
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2333 ZC Leiden, The Netherlands;
- Correspondence: (B.H.); (S.M.C.D.S.L.); Tel.: +32-9332-4748 (B.H.); +31-71-526-9350 (S.M.C.D.S.L.)
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Kanayama M, Oyama R, Mori M, Taira A, Shinohara S, Kuwata T, Takenaka M, Yoneda K, Kuroda K, Ohnaga T, Kato Y, Tanaka F. Novel circulating tumor cell-detection chip combining conventional podoplanin and EGFR antibodies for all histological malignant pleural mesothelioma. Oncol Lett 2021; 22:522. [PMID: 34025789 PMCID: PMC8130049 DOI: 10.3892/ol.2021.12783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/18/2021] [Indexed: 12/28/2022] Open
Abstract
In our previous study, a microfluidic system was developed based on podoplanin detection for capturing circulating tumor cells (CTCs), derived from malignant pleural mesothelioma (MPM). However, non-epithelioid MPM shows low podoplanin protein expression compared with that in epithelioid MPM; thus, some CTC populations may be missed. To overcome this limitation, a new CTC-detection chip was developed by combining the conventional podoplanin antibody (clone: NZ-1.2) with an epidermal growth factor receptor (EGFR)-targeted antibody (cetuximab). The cell-capture efficiency of the Cocktail-chip reached 100% in all the histological MPM cell lines. The median CTC-counts from 19 patients with MPM (epithelioid/non-epithelioid: 10/9) with the NZ-1.2- and Cocktail-chips were 1 and 3 (P=0.311) in 1 ml peripheral blood, 1.5 and 2 (P=0.332) in epithelioid MPM, and 1 and 3 (P=0.106) in non-epithelioid MPM, respectively. Overall, the Cocktail-chip showed an improved ability to detect more CTCs in patients with non-epithelioid MPM compared with that in the conventional NZ-1.2-chip, showing non-significant, but higher CTC detection. Furthermore, CTC-counts, determined using the Cocktail-chip were significantly correlated with the clinical stage of non-epithelioid MPM. In epithelioid MPM, the Cocktail-chip achieved a CTC-detection efficiency equivalent to that in the conventional NZ-1.2-chip. The Cocktail-chip enabled sensitive CTC detection of all histological MPM, including the non-epithelioid subtype, which may provide a foundation for the diagnosis, treatment, and prognosis of MPM progression.
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Affiliation(s)
- Masatoshi Kanayama
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Rintaro Oyama
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Masataka Mori
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Akihiro Taira
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Shinji Shinohara
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Taiji Kuwata
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Masaru Takenaka
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Kazue Yoneda
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Koji Kuroda
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Takashi Ohnaga
- Central Research Laboratories, Toyama Industrial Technology Center, Takaoka, Toyama 933-0981, Japan
| | - Yukinari Kato
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8575, Japan.,New Industry Creation Hatchery Center, Tohoku University, Sendai, Miyagi 980-8575, Japan
| | - Fumihiro Tanaka
- Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
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Abstract
Despite multiple diagnostic toolkits, the diagnosis of diffuse malignant pleural mesothelioma relies primarily on proper histologic assessment. The definitive diagnosis of diffuse malignant pleural mesothelioma is based on the pathologic assessment of tumor tissue, which can be obtained from core biopsy sampling, pleurectomy, or other more extensive resections, such as extrapleural pneumonectomy. Given its rarity and overlapping microscopic features with other conditions, the histologic diagnosis of diffuse malignant pleural mesothelioma is challenging. This review discusses the pathologic features and the differential diagnosis of diffuse malignant pleural mesothelioma, including select diagnostic pitfalls.
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Affiliation(s)
- Yin P Hung
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Lucian R Chirieac
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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An Algorithmic Immunohistochemical Approach to Define Tumor Type and Assign Site of Origin. Adv Anat Pathol 2020; 27:114-163. [PMID: 32205473 DOI: 10.1097/pap.0000000000000256] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Immunohistochemistry represents an indispensable complement to an epidemiology and morphology-driven approach to tumor diagnosis and site of origin assignment. This review reflects the state of my current practice, based on 15-years' experience in Pathology and a deep-dive into the literature, always striving to be better equipped to answer the age old questions, "What is it, and where is it from?" The tables and figures in this manuscript are the ones I "pull up on the computer" when I am teaching at the microscope and turn to myself when I am (frequently) stuck. This field is so exciting because I firmly believe that, through the application of next-generation immunohistochemistry, we can provide better answers than ever before. Specific topics covered in this review include (1) broad tumor classification and associated screening markers; (2) the role of cancer epidemiology in determining pretest probability; (3) broad-spectrum epithelial markers; (4) noncanonical expression of broad tumor class screening markers; (5) a morphologic pattern-based approach to poorly to undifferentiated malignant neoplasms; (6) a morphologic and immunohistochemical approach to define 4 main carcinoma types; (7) CK7/CK20 coordinate expression; (8) added value of semiquantitative immunohistochemical stain assessment; algorithmic immunohistochemical approaches to (9) "garden variety" adenocarcinomas presenting in the liver, (10) large polygonal cell adenocarcinomas, (11) the distinction of primary surface ovarian epithelial tumors with mucinous features from metastasis, (12) tumors presenting at alternative anatomic sites, (13) squamous cell carcinoma versus urothelial carcinoma, and neuroendocrine neoplasms, including (14) the distinction of pheochromocytoma/paraganglioma from well-differentiated neuroendocrine tumor, site of origin assignment in (15) well-differentiated neuroendocrine tumor and (16) poorly differentiated neuroendocrine carcinoma, and (17) the distinction of well-differentiated neuroendocrine tumor G3 from poorly differentiated neuroendocrine carcinoma; it concludes with (18) a discussion of diagnostic considerations in the broad-spectrum keratin/CD45/S-100-"triple-negative" neoplasm.
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Targeted Phototherapy for Malignant Pleural Mesothelioma: Near-Infrared Photoimmunotherapy Targeting Podoplanin. Cells 2020; 9:cells9041019. [PMID: 32326079 PMCID: PMC7225918 DOI: 10.3390/cells9041019] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/22/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) has extremely limited treatment despite a poor prognosis. Moreover, molecular targeted therapy for MPM has not yet been implemented; thus, a new targeted therapy is highly desirable. Near-infrared photoimmunotherapy (NIR-PIT) is a recently developed cancer therapy that combines the specificity of antibodies for targeting tumors with toxicity induced by the photoabsorber after exposure to NIR-light. In this study, we developed a new phototherapy targeting podoplanin (PDPN) for MPM with the use of both NIR-PIT and an anti-PDPN antibody, NZ-1. An antibody–photosensitizer conjugate consisting of NZ-1 and phthalocyanine dye was synthesized. In vitro NIR-PIT-induced cytotoxicity was measured with both dead cell staining and luciferase activity on various MPM cell lines. In vivo NIR-PIT was examined in both the flank tumor and orthotopic mouse model with in vivo real-time imaging. In vitro NIR-PIT-induced cytotoxicity was NIR-light dose dependent. In vivo NIR-PIT led to significant reduction in both tumor volume and luciferase activity in a flank model (p < 0.05, NIR-PIT group versus NZ-1-IR700 group). The PDPN-targeted NIR-PIT resulted in a significant antitumor effect in an MPM orthotopic mouse model (p < 0.05, NIR-PIT group versus NZ-1-IR700 group). This study suggests that PDPN-targeted NIR-PIT could be a new promising treatment for MPM.
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Kuwata T, Yoneda K, Mori M, Kanayama M, Kuroda K, K. Kaneko M, Kato Y, Tanaka F. Detection of Circulating Tumor Cells (CTCs) in Malignant Pleural Mesothelioma (MPM) with the "Universal" CTC-Chip and An Anti-Podoplanin Antibody NZ-1.2. Cells 2020; 9:cells9040888. [PMID: 32260559 PMCID: PMC7226802 DOI: 10.3390/cells9040888] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/22/2020] [Accepted: 04/02/2020] [Indexed: 12/28/2022] Open
Abstract
Circulating tumor cell (CTC) is a potentially useful surrogate of micro-metastasis, but detection of rare tumor cells contaminated in a vast majority of normal hematologic cells remains technical challenges. To achieve effective detection of a variety of CTCs, we have developed a novel microfluidic system (CTC-chip) in which any antibody to capture CTCs is easily conjugated. In previous studies, we employed an antibody (clone E-1) against podoplanin that was strongly expressed on mesothelioma cells. The CTC-chip coated by the E-1 antibody (E1-chip) provided a modest sensitivity in detection of CTCs in malignant pleural mesothelioma (MPM). Here, to achieve a higher sensitivity, we employed a novel anti-podoplanin antibody (clone NZ-1.2). In an experimental model, MPM cells with high podoplanin expression were effectively captured with the CTC-chip coated by the NZ-1.2 antibody (NZ1.2-chip). Next, we evaluated CTCs in the peripheral blood sampled from 22 MPM patients using the NZ1.2-chip and the E1-chip. One or more CTCs were detected in 15 patients (68.2%) with the NZ1.2-chip, whereas only in 10 patients (45.5%) with the E1-chip. Of noted, in most (92.3%, 12/13) patients with epithelioid MPM subtype, CTCs were positive with the NZ1.2-chip. The CTC-count detected with the NZ1.2-chip was significantly higher than that with the E1-chip (p = 0.034). The clinical implications of CTCs detected with the NZ1.2-chip will be examined in a future study.
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Affiliation(s)
- Taiji Kuwata
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; (T.K.); (M.M.); (M.K.); (K.K.); (F.T.)
| | - Kazue Yoneda
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; (T.K.); (M.M.); (M.K.); (K.K.); (F.T.)
- Correspondence: ; Tel.: +81-93-691-7442
| | - Masataka Mori
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; (T.K.); (M.M.); (M.K.); (K.K.); (F.T.)
| | - Masatoshi Kanayama
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; (T.K.); (M.M.); (M.K.); (K.K.); (F.T.)
| | - Koji Kuroda
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; (T.K.); (M.M.); (M.K.); (K.K.); (F.T.)
| | - Mika K. Kaneko
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (M.K.K.); (Y.K.)
| | - Yukinari Kato
- Department of Antibody Drug Development, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (M.K.K.); (Y.K.)
- New Industry Creation Hatchery Center, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Fumihiro Tanaka
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; (T.K.); (M.M.); (M.K.); (K.K.); (F.T.)
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Le Stang N, Burke L, Blaizot G, Gibbs AR, Lebailly P, Clin B, Girard N, Galateau-Sallé F. Differential Diagnosis of Epithelioid Malignant Mesothelioma With Lung and Breast Pleural Metastasis: A Systematic Review Compared With a Standardized Panel of Antibodies-A New Proposal That May Influence Pathologic Practice. Arch Pathol Lab Med 2020; 144:446-456. [PMID: 31389715 DOI: 10.5858/arpa.2018-0457-oa] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT.— Pleural mesothelioma is a rare cancer with an often-challenging diagnosis because of its potential to be a great mimicker of many other tumors. Among them, primary lung and breast cancers are the 2 main causes of pleural metastasis. The development and application of targeted therapeutic agents have made it even more important to achieve an accurate diagnosis. In this setting, international guidelines have recommended the use of 2 positive and 2 negative immunohistochemical biomarkers. OBJECTIVES.— To define the most highly specific and sensitive minimum set of antibodies for routine practice to use for the separation of epithelioid malignant mesothelioma from lung and breast metastasis and to determine the most relevant expression cutoff. DESIGN.— To provide information at different levels of expression of 16 mesothelial and epithelial biomarkers, we performed a systematic review of articles published between 1979 and 2017, and we compared those data to results from the Mesothelioma Telepathology Network (MESOPATH) of the standardized panel used in routine practice database since 1998. RESULTS.— Our results indicate that the following panel of markers-calretinin (poly)/thyroid transcription factor 1 (TTF-1; clone 8G7G3/1) and calretinin (poly)/estrogen receptor-α (ER-α; clone EP1)-should be recommended; ultimately, based on the MESOPATH database, we highlight their relevance which are the most sensitive and specific panel useful to the differential diagnosis at 10% cutoff. CONCLUSIONS.— Highlighted by their relevance in the large cohort reported, we recommend 2 useful panels to the differential diagnosis at 10% cutoff.
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Affiliation(s)
- Nolwenn Le Stang
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Louise Burke
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Gaetane Blaizot
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Allen R Gibbs
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Pierre Lebailly
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Bénédicte Clin
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Nicolas Girard
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
| | - Françoise Galateau-Sallé
- From the Pleural Mesothelioma National Multicentric Registry (MESONAT), MESOPATH National Network on Mesothelioma (Ms Le Stang and Dr Galateau-Sallé), the EURACAN network (Dr Girard), and MESOBANK Clinicobiological Database and National Frozen Tissue Bank (Dr Galateau-Sallé), Léon Bérard Cancer Center, Lyon, France; the Department of Pathology, Cork University Hospital, Cork, Ireland (Dr Burke); the Frozen Tissue Bank InnovaBio, CHU de Caen, France (Ms Blaizot); the Department of Pathology, University Hospital Llandough, Cardiff, England (Dr Gibbs); INSERM U1086, ANTICIPE, Caen University, Caen, France (Drs Lebailly and Clin); the Department of Occupational Diseases, University Hospital, Caen, France (Dr Clin); the University of Lyon, Lyon, France (Dr Girard); and the Curie Montsouris Thorax Institute, Curie Institut, Paris, France (Dr Girard)
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10
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Chapel DB, Schulte JJ, Husain AN, Krausz T. Application of immunohistochemistry in diagnosis and management of malignant mesothelioma. Transl Lung Cancer Res 2020; 9:S3-S27. [PMID: 32206567 PMCID: PMC7082260 DOI: 10.21037/tlcr.2019.11.29] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Immunohistochemistry plays an indispensable role in accurate diagnosis of malignant mesothelioma, particularly in morphologically challenging cases and in biopsy and cytology specimens, where tumor architecture is difficult or impossible to evaluate. Application of a targeted panel of mesothelial- and epithelial-specific markers permits correct identification of tumor lineage in the vast majority of cases. An immunopanel including two mesothelial markers (calretinin, CK5/6, WT-1, or D2-40) and two epithelial markers (MOC-31 and claudin-4) offers good sensitivity and specificity, with adjustments as appropriate for the differential diagnosis. Once mesothelial lineage is established, malignancy-specific studies can help verify a diagnosis of malignant mesothelioma. BAP1 loss, CDKN2A homozygous deletion, and MTAP loss are highly specific markers of malignancy in a mesothelial lesion, and they attain acceptable diagnostic sensitivity when applied as a diagnostic panel. Novel markers of malignancy, such as 5-hmC loss and increased EZH2 expression, are promising, but have not yet achieved widespread clinical adoption. Some diagnostic markers also have prognostic significance, and PD-L1 immunohistochemistry may predict tumor response to immunotherapy. Application and interpretation of these immnuomarkers should always be guided by clinical history, radiographic findings, and above all histomorphology.
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Affiliation(s)
- David B Chapel
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Jefree J Schulte
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA
| | - Aliya N Husain
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA
| | - Thomas Krausz
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA
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11
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Calretinin-expressing lung adenocarcinoma: Distinct characteristics of advanced stages, smoker-type features, and rare expression of other mesothelial markers are useful to differentiate epithelioid mesothelioma. Pathol Res Pract 2020; 216:152817. [PMID: 32008868 DOI: 10.1016/j.prp.2020.152817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 01/24/2023]
Abstract
Calretinin, a mesothelioma marker, is sometimes expressed in lung cancer, which may complicate the differential diagnosis of mesothelioma. Here, the clinicopathological and immunohistochemical characteristics of calretinin-positive lung cancer were examined to reduce confusion with malignant mesothelioma. Calretinin expression in 307 consecutive cases of lung cancer was evaluated immunohistochemically. Survival was analyzed using the Kaplan-Meier method and log-rank test. Calretinin expression was identified in 67 (22%) tumors, including those with partial and weak expression [15% (37/250) of adenocarcinomas, 54% (25/46) of squamous cell carcinomas, 75% (3/4) of adenosquamous carcinomas, and 29% (2/7) of sarcomatoid carcinomas]. In calretinin-positive adenocarcinoma (n = 37), expression percentages of Wilms tumor-1, podoplanin, thyroid transcription factor-1, and claudin-4 were 6, 3, 52, 82%, respectively, whereas in calretinin-positive squamous cell carcinoma (n = 25) the percentages were 8, 12, 12, 68%, respectively, indicating that other mesothelial markers were only rarely expressed and that claudin-4 expression was common. Although not an independent marker, calretinin expression was associated with a poor prognosis for stage I tumors of adenocarcinoma (p < 0.001) and of all histological subtypes (p < 0.001). In conclusion, calretinin-positive lung tumors share characteristics with those of smokers and advanced stages and can be differentiated from mesothelioma with the use of other mesothelial and epithelial markers.
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12
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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 2017; 67:160-168. [DOI: 10.1016/j.humpath.2017.07.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/21/2017] [Accepted: 07/27/2017] [Indexed: 11/22/2022]
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13
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He C, Wang B, Wan C, Yang T, Shen Y. Diagnostic value of D2-40 immunostaining for malignant mesothelioma: a meta-analysis. Oncotarget 2017; 8:64407-64416. [PMID: 28969080 PMCID: PMC5610012 DOI: 10.18632/oncotarget.19041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/18/2017] [Indexed: 02/05/2023] Open
Abstract
Malignant mesothelioma (MM) has become a global disease burden for its rising incidence and invariable fatality. D2-40 has been widely used as an immunostaining marker of diagnosing MM, while its diagnostic value has not yet been evaluated. Our study aimed to assess the overall accuracy of D2-40 immunostaining for diagnosing MM through a meta-analysis. A total of 22 studies with 2,264 participants were identified from PubMed, EMBASE, Web of Science, Scopus and the Cochrane database. The pooled sensitivity and specificity of D2-40 for MM was 0.86 (95% CI: 0.84–0.89) and 0.77 (95% CI: 0.74–0.79), respectively. The area under the summary receiver operating characteristic curve is 0.93, with a diagnostic odds ratio 40.37 (95% CI: 19.97–81.61). None of the study variates was found to be a source of heterogeneity after meta-regression analysis. In conclusion, D2-40 immunostaining may not give sufficient evidence by itself to diagnose MM and should be in combination with other markers to improve the accuracy of diagnosis.
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Affiliation(s)
- Chao He
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Bo Wang
- Intensive Care Unit, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Chun Wan
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Ting Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Yongchun Shen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
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14
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Amatya VJ, Kushitani K, Mawas AS, Miyata Y, Okada M, Kishimoto T, Inai K, Takeshima Y. MUC4, a novel immunohistochemical marker identified by gene expression profiling, differentiates pleural sarcomatoid mesothelioma from lung sarcomatoid carcinoma. Mod Pathol 2017; 30:672-681. [PMID: 28128276 DOI: 10.1038/modpathol.2016.181] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/03/2016] [Accepted: 09/06/2016] [Indexed: 11/09/2022]
Abstract
Sarcomatoid mesothelioma, a histological subtype of malignant pleural mesothelioma, is a very aggressive tumor with a poor prognosis. Histological diagnosis of sarcomatoid mesothelioma largely depends on the histomorphological feature of spindled tumor cells with immunohistochemical reactivity to cytokeratins. Diagnosis also requires clinico-radiological and/or macroscopic evidence of an extrapulmonary location to differentiate it from lung sarcomatoid carcinoma. Although there are promising immunohistochemical antibody panels to differentiate mesothelioma from lung carcinoma, a consensus on the immunohistochemical markers that distinguish sarcomatoid mesothelioma from lung sarcomatoid carcinoma has not been reached and requires further study. We performed whole gene expression analysis of formalin-fixed paraffin-embedded tissue from sarcomatoid mesothelioma and lung sarcomatoid carcinoma and observed significant differences in the expression of MUC4 and other genes between sarcomatoid mesothelioma and lung sarcomatoid carcinoma. Immunohistochemistry demonstrated that MUC4 was expressed in the spindled tumor cells of lung sarcomatoid carcinoma (21/29, 72%) but was not expressed in any sarcomatoid mesothelioma (0/31, 0%). To differentiate sarcomatoid mesothelioma from lung sarcomatoid carcinoma, negative MUC4 expression showed 100% sensitivity and 72% specificity and accuracy rate of 87%, which is higher than immunohistochemical markers such as calretinin, D2-40 and Claudin-4. Therefore, we recommend to include MUC4 as a novel and useful negative immunohistochemical marker for differentiating sarcomatoid mesothelioma from lung sarcomatoid carcinoma.
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Affiliation(s)
- Vishwa Jeet Amatya
- Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kei Kushitani
- Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Amany Sayed Mawas
- Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Department of Pathology and Clinical Pathology, South Valley University, Qena, Egypt
| | - Yoshihiro Miyata
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Takumi Kishimoto
- Department of Internal Medicine, Okayama Rosai Hospital, Okayama, Japan
| | - Kouki Inai
- Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.,Pathologic Diagnostic Center, Inc., Hiroshima, Japan
| | - Yukio Takeshima
- Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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15
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Tsuji S, Washimi K, Kageyama T, Yamashita M, Yoshihara M, Matsuura R, Yokose T, Kameda Y, Hayashi H, Morohoshi T, Tsuura Y, Yusa T, Sato T, Togayachi A, Narimatsu H, Nagasaki T, Nakamoto K, Moriwaki Y, Misawa H, Hiroshima K, Miyagi Y, Imai K. HEG1 is a novel mucin-like membrane protein that serves as a diagnostic and therapeutic target for malignant mesothelioma. Sci Rep 2017; 7:45768. [PMID: 28361969 PMCID: PMC5374711 DOI: 10.1038/srep45768] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/02/2017] [Indexed: 12/24/2022] Open
Abstract
The absence of highly specific markers for malignant mesothelioma (MM) has served an obstacle for its diagnosis and development of molecular-targeting therapy against MM. Here, we show that a novel mucin-like membrane protein, sialylated protein HEG homolog 1 (HEG1), is a highly specific marker for MM. A monoclonal antibody against sialylated HEG1, SKM9-2, can detect even sarcomatoid and desmoplastic MM. The specificity and sensitivity of SKM9-2 to MM reached 99% and 92%, respectively; this antibody did not react with normal tissues. This accurate discrimination by SKM9-2 was due to the recognition of a sialylated O-linked glycan with HEG1 peptide. We also found that gene silencing of HEG1 significantly suppressed the survival and proliferation of mesothelioma cells; this result suggests that HEG1 may be a worthwhile target for function-inhibition drugs. Taken together, our results indicate that sialylated HEG1 may be useful as a diagnostic and therapeutic target for MM.
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Affiliation(s)
- Shoutaro Tsuji
- Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Kota Washimi
- Kanagawa Cancer Center Research Institute, Yokohama, Japan.,Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | | | | | | | - Rieko Matsuura
- Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoichi Kameda
- Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Takao Morohoshi
- Division of General Thoracic Surgery, Yokosuka-Kyosai Hospital, Yokosuka, Japan
| | - Yukio Tsuura
- Division of Pathology, Yokosuka-Kyosai Hospital, Yokosuka, Japan
| | - Toshikazu Yusa
- Department of General Thoracic Surgery and Asbestos Disease Center, Chiba Rosai Hospital, Ichihara, Japan
| | - Takashi Sato
- Research Center for Medical Glycoscience, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Akira Togayachi
- Research Center for Medical Glycoscience, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Hisashi Narimatsu
- Research Center for Medical Glycoscience, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Toshinori Nagasaki
- Kanagawa Cancer Center Research Institute, Yokohama, Japan.,Division of Pharmacology, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Kotaro Nakamoto
- Kanagawa Cancer Center Research Institute, Yokohama, Japan.,Division of Pharmacology, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Yasuhiro Moriwaki
- Division of Pharmacology, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Hidemi Misawa
- Division of Pharmacology, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Kenzo Hiroshima
- Department of Pathology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Japan
| | - Yohei Miyagi
- Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Kohzoh Imai
- Kanagawa Cancer Center Research Institute, Yokohama, Japan.,Institute of Medical Science, University of Tokyo, Tokyo, Japan
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16
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The established and future biomarkers of malignant pleural mesothelioma. Cancer Treat Rev 2015; 41:486-95. [DOI: 10.1016/j.ctrv.2015.05.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 04/27/2015] [Accepted: 05/02/2015] [Indexed: 12/18/2022]
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17
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Shetuni BB, Irtaza U, Melnyk J, Chou PM, Rao S, Yang GY. Rhabdoid carcinoma of anal canal: role of electron microscopy and immunohistochemistry in establishing lineage. Ultrastruct Pathol 2014; 38:425-9. [PMID: 25192454 DOI: 10.3109/01913123.2014.952469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACT Rhabdoid carcinoma is a high-grade carcinoma with rhabdoid features and it is different from rhabdoid tumors that are broadly defined as malignant neoplasms with rhabdoid cellular appearance found primarily in the pediatric population, but adult cases have been reported in many anatomic locations. To date, no cases of anal canal rhabdoid carcinoma have been reported in the adult or pediatric population. We are reporting the first case of anal canal rhabdoid carcinoma, found in a 75-year-old male. We utilized ultrastructural as well as immunohistochemical studies to arrive at our diagnosis. Ultrastructural studies demonstrated the intermediate filament congregating to impart a rhabdoid appearance to tumor cells, and cytokeratin intermediate filaments and short microvilli indicating nature of tumor as carcinoma. Immunohistochemical phenotype showed neoplastic cells were positive for vimentin, pan-cytokeratin AE1/3, p63 and D2-40, which supports the genesis of tumor from skin adnexa. Even in the modern era of surgical pathology that routinely utilizes immunohistochemistry and molecular studies, adequate use of electron microscopy to help pinpoint the diagnosis in challenging cases is important.
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Affiliation(s)
- Brandon Bassian Shetuni
- Department of Pathology, Northwestern University, Feinberg School of Medicine , Chicago, IL , USA
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18
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Terra SBSP, Aubry MC, Yi ES, Boland JM. Immunohistochemical study of 36 cases of pulmonary sarcomatoid carcinoma--sensitivity of TTF-1 is superior to napsin. Hum Pathol 2013; 45:294-302. [PMID: 24331839 DOI: 10.1016/j.humpath.2013.09.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/06/2013] [Accepted: 09/11/2013] [Indexed: 10/25/2022]
Abstract
Immunohistochemistry is often used to distinguish pulmonary sarcomatoid carcinoma from morphologic mimics. Napsin-A is a pulmonary adenocarcinoma marker, but literature on expression in sarcomatoid carcinoma is limited. Thirty-six cases of sarcomatoid carcinoma were stained for napsin, TTF-1, Oscar, CAM5.2, AE1/AE3, desmin, SMA, S-100, CK5/6, calretinin, D2-40, and WT1. Patients were 24 men and 12 women (mean, 70 years; range, 46-93). There were 27 pleomorphic carcinomas, 5 spindle cell carcinomas, 3 carcinosarcomas, and 1 giant cell carcinoma. Cases were positive for at least 1 keratin: AE1/3 was positive in all 36 cases; Oscar, in 34 cases (94%); and CAM5.2, in 32 cases (89%, weaker/more focal). Napsin was positive in 14 cases (39%): 8 diffuse, 3 focal, and 3 rare cells. TTF-1 was positive in 22 cases (61%): 15 diffuse, 3 focal, and 4 rare cells. No cases were napsin positive and negative for TTF-1. Variable staining for mesothelial markers was observed, including positivity for calretinin (12 cases, 33%), WT1 (6 cases, 17%), D2-40 (5 cases, 14%), and CK5/6 (9 cases, 25%). Mesenchymal markers were also sometimes positive (usually focal), including S-100 (4 cases, 11%), desmin (4 cases, 11%), and SMA (7 cases, 19%, 1 diffuse). In conclusion, TTF-1 is more sensitive than napsin for detection of sarcomatoid carcinoma, and no cases were positive for napsin but negative for TTF-1. CAM5.2 is less sensitive than AE1/AE3 and Oscar. Use of a thoughtful immunohistochemical panel is important in the evaluation of sarcomatoid carcinoma because mesothelial and mesenchymal markers can be expressed.
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Affiliation(s)
- Simone B S P Terra
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Marie Christine Aubry
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Eunhee S Yi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer M Boland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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19
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Seki S, Fujiwara M, Matsuura M, Fujita S, Ikeda H, Umeda M, Asahina I, Ikeda T. Prognostic value of podoplanin expression in oral squamous cell carcinoma--a regression model auxiliary to UICC classification. Pathol Oncol Res 2013; 20:521-8. [PMID: 24281769 DOI: 10.1007/s12253-013-9723-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 11/05/2013] [Indexed: 12/17/2022]
Abstract
Podoplanin, a type I transmembrane glycoprotein with an effect of platelet aggregation, has been reported to be one of the possible prognostic factors of oral squamous cell carcinoma (OSCC). However, the biological significance of podoplanin is largely unclear. The aim of this study was to develop a practical model for the prediction of prognosis using the grade of podoplanin expression, and also to evaluate the biological function of podoplanin. Eighty-two specimens of patients with previously untreated OSCC, who underwent either biopsy or surgery, were histopathologically and immunohistochemically analyzed. These 82 cases were composed of 66 well-differentiated, 10 moderately differentiated and 6 poorly differentiated OSCC. Podoplanin was successfully immunostained in 78 specimens, and was detected in most cases, but the frequency of positive cells varied. The prognosis of patients with more than 50 % podoplanin-positive tumor cells was significantly poorer than that of the other patients. Multivariate hazards regression analysis suggested that a linear combination of covariates, OSCC patients with more or less than 50 % podoplanin expression, age of more or less than 70 years old, mode of invasion and T3, T4 or T2 versus T1 of the UICC T-stage classification was the most effective model for evaluating the prognosis of OSCC patients. Additionally, podoplanin expression had a significant relationship to UICC clinical stage and the expression of Ki-67. An effective regression model using podoplanin expression was developed for evaluating the prognosis of OSCC and the biological significance of podoplanin was suggested to be associated with the growth and/or progression of OSCC.
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Affiliation(s)
- Sachiko Seki
- Department of Oral Pathology and Bone Metabolism, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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20
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Synovial cysts of the temporomandibular joint: an immunohistochemical characterization and literature review. Case Rep Pathol 2013; 2013:508619. [PMID: 23573446 PMCID: PMC3616358 DOI: 10.1155/2013/508619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 02/25/2013] [Indexed: 11/18/2022] Open
Abstract
Synovial cysts of the temporomandibular joint (TMJ) are very rare, and to date, only 12 cases of a synovial cyst in the TMJ region have been reported in the literature. In this paper, we present the clinicopathological and immunohistochemical characteristics of one such lesion affecting a 48-year-old woman, presented with a mass in the left preauricular region. We describe the usefulness of immunohistochemical analysis for recognizing the synovial lining, which allowed for clear differentiation between ganglion and synovial cysts. Immunohistochemical analyses can be used to diagnose synovial cysts with certainty; however, using at least two markers is advisable to distinguish the two existing synovial cell subtypes. Our findings indicate that synovial cysts of TMJ possess an internal lining dominated by type B (fibroblast-like) synoviocytes.
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21
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Value of thyroid transcription factor-1 immunostaining in tumor diagnosis: a review and update. Appl Immunohistochem Mol Morphol 2013; 20:429-44. [PMID: 22531688 DOI: 10.1097/pai.0b013e31825439bc] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Thyroid transcription factor-1 (TTF-1) is a tissue-specific transcription factor that plays a critical role in the normal development of embryonic epithelial cells of the thyroid and lung. Because TTF-1 expression is highly restricted to epithelial tumors arising in these organs, it is, at present, one of the immunohistochemical markers most commonly used to assist in the differential diagnosis of carcinomas of the lung and thyroid. Recent studies, however, have reported that TTF-1 is not as specific for lung and thyroid carcinomas as was previously thought as it can be found to be expressed, although much less frequently, in some carcinomas arising in other organs, such as the ovaries, endometrium, colon, and breast, as well as in some tumors of the central nervous system. Even though this unexpected TTF-1 positivity has been reported more frequently with the recently available SPT24 anti-TTF-1 monoclonal antibody, it has also been shown to occur with the commonly used 8G7G3/1 clone, albeit in a lower percentage of cases. Despite these findings, TTF-1 remains a very useful immunohistochemical marker in diagnostic pathology.
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22
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YAMAKI EI, YAJIMA TOSHIKI, KOSAKA TAKAYUKI, MOGI AKIRA, TANAKA SHIGEBUMI, KUWANO HIROYUKI. Podoplanin overexpression in human mesothelioma cell lines enhances the tumorigenic phenotype. Oncol Rep 2013; 29:932-40. [DOI: 10.3892/or.2013.2225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/19/2012] [Indexed: 11/06/2022] Open
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23
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Abstract
Malignant pleural mesothelioma (MPM) can be a challenging diagnosis for clinicians to make as it is often difficult to distinguish from benign asbestos pleural effusions and metastatic carcinomas. In this review, we present a case of MPM and discuss clinical manifestations, traditional diagnostic techniques, and the role of cytopathologic immunostains and serum biomarkers in the diagnosis of MPM.
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Washimi K, Yokose T, Yamashita M, Kageyama T, Suzuki K, Yoshihara M, Miyagi Y, Hayashi H, Tsuji S. Specific expression of human intelectin-1 in malignant pleural mesothelioma and gastrointestinal goblet cells. PLoS One 2012; 7:e39889. [PMID: 22768319 PMCID: PMC3388067 DOI: 10.1371/journal.pone.0039889] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/28/2012] [Indexed: 11/18/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a fatal tumor. It is often hard to discriminate MPM from metastatic tumors of other types because currently, there are no reliable immunopathological markers for MPM. MPM is differentially diagnosed by some immunohistochemical tests on pathology specimens. In the present study, we investigated the expression of intelectin-1, a new mesothelioma marker, in normal tissues in the whole body and in many cancers, including MPM, by immunohistochemical analysis. We found that in normal tissues, human intelectin-1 was mainly secreted from gastrointestinal goblet cells along with mucus into the intestinal lumen, and it was also expressed, to a lesser extent, in mesothelial cells and urinary epithelial cells. Eighty-eight percent of epithelioid-type MPMs expressed intelectin-1, whereas sarcomatoid-type MPMs, biphasic MPMs, and poorly differentiated MPMs were rarely positive for intelectin-1. Intelectin-1 was not expressed in other cancers, except in mucus-producing adenocarcinoma. These results suggest that intelectin-1 is a better marker for epithelioid-type MPM than other mesothelioma markers because of its specificity and the simplicity of pathological assessment. Pleural intelectin-1 could be a useful diagnostic marker for MPM with applications in histopathological identification of MPM.
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Affiliation(s)
- Kota Washimi
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Makiko Yamashita
- Molecular Diagnostic Project, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Taihei Kageyama
- Molecular Diagnostic Project, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Katsuo Suzuki
- Molecular Diagnostic Project, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Mitsuyo Yoshihara
- Division of Molecular Pathology and Genetics, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Yohei Miyagi
- Division of Molecular Pathology and Genetics, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan
| | - Shoutaro Tsuji
- Molecular Diagnostic Project, Kanagawa Cancer Center Research Institute, Yokohama, Japan
- * E-mail:
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Betta PG, Magnani C, Bensi T, Trincheri NF, Orecchia S. Immunohistochemistry and Molecular Diagnostics of Pleural Malignant Mesothelioma. Arch Pathol Lab Med 2012; 136:253-61. [DOI: 10.5858/arpa.2010-0604-ra] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—The pathologic approach to pleural-based lesions is stepwise and uses morphologic assessment, correlated with clinical and imaging data supplemented by immunohistochemistry (IHC), and more recently, molecular tests, as an aid for 2 main diagnostic problems: malignant mesothelioma (MM) versus other malignant tumors and malignant versus reactive mesothelial proliferations.
Objective.—To present the current knowledge regarding IHC and molecular tests with respect to MM diagnosis, and in particular, the differentiation of the epithelioid type of MM from carcinoma metastatic to the pleural cavity.
Data Sources.—A review of immunohistochemical features of 286 consecutive MMs from 459 cases of pleural pathology, diagnosed during routine practice from 2003 to 2009. A survey of biomedical journal literature from MedLine/PubMed (US National Library of Medicine) focused on MM and associated tissue-based diagnostic IHC markers and molecular tests.
Conclusions.—The search for a single diagnostic marker of MM has so far been discouraging, given the biologic and phenotypic tumor heterogeneity of MM. The use of antibody panels has gained unanimous acceptance especially in the differential diagnosis between MM and metastatic carcinoma, whereas the usefulness of IHC is more limited when dealing with spindle cell malignancies or distinguishing malignant from reactive mesothelium. A great degree of interlaboratory variability in antibody combinations and clone selection within diagnostic panels still exists. Current investigations aim at selecting the most suitable and cost-effective combination of antibodies by using novel statistical approaches for assessing diagnostic performance beyond the traditional measures of sensitivity and specificity.
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Abstract
Context.—Diagnosing epithelioid serosal lesions remains a challenge because numerous different processes—primary or secondary, benign or malignant—occur in body cavities, some of which are very rare.
Objectives.—To review the newest literature and to describe the morphologic criteria and immunohistochemical markers that are useful for distinguishing epithelioid serosal lesions.
Data Sources.—Previously published literature concentrating on the newest research findings. Earlier reviews are principally referred to for established diagnostic criteria.
Conclusions.—Immunohistochemistry with a panel of antibodies has made the diagnosis of epithelioid serosal lesions very reliable. When deciding on antibodies used in differential diagnosis, it is important to consider tumor location, clinical and radiologic information, and morphologic features. Immunohistochemistry is less useful in the differential diagnosis of benign versus malignant mesothelial lesions. The diagnosis of benign versus malignant mesothelial proliferations still relies on the histologic criteria of invasion.
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Tong L, Yuan S, Feng F, Zhang H. Role of podoplanin expression in esophageal squamous cell carcinoma: a retrospective study. Dis Esophagus 2012; 25:72-80. [PMID: 21895849 DOI: 10.1111/j.1442-2050.2011.01211.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Lymphatic metastasis is the predominant cause of the low overall survival of patients with esophageal squamous cell carcinoma (ESCC), as there are no faithful methods available predicting early metastasis. Recent studies suggest an effect of podoplanin expression on metastatic spreading to lymph nodes. The purpose of this study was to investigate the influence of podoplanin expression on lymphatic metastasis and tumor cells, and to find the relationship between podoplanin expression and prognosis of patients with ESCC. We evaluated the level of podoplanin expression on tumor cells and the lymphatic vessel density change of tumor mass compared with normal tissue from the same patient through D2-40 immunohistochemistry staining, and analyzed associations between these two variables and various clinicopathologic parameters individually or conjunctively. There was an association between podoplanin expression and the frequency of lymph node metastases. In 45 patients (80%), podoplanin was expressed on the tumor cells. Twenty-one patients (37.5%) showed high levels of expression. The 5-year disease-free survival rate (5%) for patients with high levels of podoplanin expression was significantly lower (P < 0.001) than for patients with low and moderate expression of podoplanin (54% and 27%, respectively). We concluded that podoplanin is expressed frequently in ESCC, and that the expression of podoplanin on cancer cells, lymphatics, or both is correlated with lymphatic metastasis and clinical outcome.
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Affiliation(s)
- L Tong
- State Key Laboratory of Cancer Biology, Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, tFourth Military Medical University, Xi'an, Shaanxi Province, China
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Sinon SH, Rich AM, Hussaini HM, Yoon HS, Firth NA, Seymour GJ. Metastases to the oral region from pleural mesothelioma: Clinicopathologic review. Head Neck 2011; 35:599-604. [DOI: 10.1002/hed.21942] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 07/02/2011] [Accepted: 08/03/2011] [Indexed: 01/15/2023] Open
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Inoue H, Miyazaki Y, Kikuchi K, Yoshida N, Ide F, Ohmori Y, Tomomura A, Sakashita H, Kusama K. Podoplanin expression during dysplasia–carcinoma sequence in the oral cavity. Tumour Biol 2011; 33:183-94. [DOI: 10.1007/s13277-011-0261-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 10/25/2011] [Indexed: 01/22/2023] Open
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Frei C, Opitz I, Soltermann A, Fischer B, Moura U, Rehrauer H, Weder W, Stahel R, Felley-Bosco E. Pleural mesothelioma side populations have a precursor phenotype. Carcinogenesis 2011; 32:1324-32. [DOI: 10.1093/carcin/bgr127] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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31
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See KC, Lee P. Advances in the diagnosis of pleural disease in lung cancer. Ther Adv Respir Dis 2011; 5:409-18. [DOI: 10.1177/1753465811408637] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Pleural disease in lung cancer can be benign or malignant with the latter carrying a grave prognosis. In this review, we describe and discuss the advances in pleural imaging, procedures, and biomarkers for the diagnosis of pleural diseases in lung cancer. Ultrasound and computed tomography are increasingly applied in the planning of pleural procedures to enhance diagnostic accuracy and safety whilst pleuroscopy gives excellent yield in excess of 93% in the evaluation of cytology negative pleural effusions. Invasion beyond the elastic layer of the visceral pleura upstages lung cancer, and may indicate a need for adjuvant chemotherapy. Biomarkers isolated from pleural fluid or tissue may aid in diagnosis and guide treatment in the future. Magnetic resonance imaging, positron emission tomography, narrow band imaging of the pleura and autofluorescence thoracoscopy are technologies that require further evaluation to better define their respective roles in the diagnostic algorithms of pleural diseases in lung cancer.
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Vinicius DLV, Scapulatempo C, Perpetuo NM, Mohamed F, de Carvalho TS, de Oliveira ATT, Segalla JGM, Carvalho AL. Prognostic and risk factors in patients with locally advanced cutaneous squamous cell carcinoma of the trunk and extremities. J Skin Cancer 2011; 2011:420796. [PMID: 21773035 PMCID: PMC3135120 DOI: 10.1155/2011/420796] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 01/23/2011] [Accepted: 03/16/2011] [Indexed: 11/24/2022] Open
Abstract
55 patients with advanced cutaneous squamous cell carcinoma (CSCC) of the trunk and extremities were studied. A Tissue Microarray was constructed using immunohistochemistry to quantify expression of the HER family, E-cadherins, and podoplanin. Clinical and histopathological factors related to lymph node metastasis and prognosis were also established. Primary tumor positivity was 25.5% for EGFR, 87.3% for HER-3, and 48.1% for HER-4. Metastases were positive for EGFR in 41.7%, for HER-3 in 83.3%, and HER-4 in 43.5%. HER-2 was negative in all samples. Membrane E-cadherin and cytoplasmic E-cadherin were positive in 47.3% and 30.2% of primary tumors and 45.5% and 27.3% of metastases, respectively. Podoplanin was positive in 41.8% of primary tumors and 41.7% of metastases. Intratumoral lymphocytic infiltrate was associated with lymph node metastasis. Patients with T3 tumors had better cancer-specific survival (CSS) than those with T4 tumors; patients with no lymph node involvement had better CSS than patients with N1 tumors. Undifferentiated tumors and hyperexpression of podoplanin were negative prognostic indicators on multivariate analysis.
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Affiliation(s)
- de Lima Vazquez Vinicius
- Department of Surgery and Pathology, Hospital de Câncer de Barretos, Rua Antenor Duarte Villela, 1331-Bairro Paulo Prata, 14784-400 Barretos, SP, Brazil
| | - Cristovam Scapulatempo
- Department of Surgery and Pathology, Hospital de Câncer de Barretos, Rua Antenor Duarte Villela, 1331-Bairro Paulo Prata, 14784-400 Barretos, SP, Brazil
| | - Natalia Martins Perpetuo
- Department of Surgery and Pathology, Hospital de Câncer de Barretos, Rua Antenor Duarte Villela, 1331-Bairro Paulo Prata, 14784-400 Barretos, SP, Brazil
| | - Faheez Mohamed
- Division of Surgery, Basingstoke and North Hampshire NHS Foundation Trust, ldermaston Road Basingstoke, Hampshire RG24 9NA, UK
| | - Teóclito Sachetto de Carvalho
- Department of Surgery and Pathology, Hospital de Câncer de Barretos, Rua Antenor Duarte Villela, 1331-Bairro Paulo Prata, 14784-400 Barretos, SP, Brazil
| | - Antônio Talvane Torres de Oliveira
- Department of Surgery and Pathology, Hospital de Câncer de Barretos, Rua Antenor Duarte Villela, 1331-Bairro Paulo Prata, 14784-400 Barretos, SP, Brazil
| | | | - André Lopes Carvalho
- Department of Surgery and Pathology, Hospital de Câncer de Barretos, Rua Antenor Duarte Villela, 1331-Bairro Paulo Prata, 14784-400 Barretos, SP, Brazil
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Value of D2-40 in the differential diagnosis of pleural neoplasms with emphasis on its positivity in solitary fibrous tumor. Appl Immunohistochem Mol Morphol 2011; 18:411-3. [PMID: 20436345 DOI: 10.1097/pai.0b013e3181da8387] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
D2-40 is a new monoclonal antibody recognizing podoplanin and it is selective for lymphatic endothelium. Several studies have confirmed the reliability of D2-40 in the diagnosis of pleural malignant mesothelioma, but the evaluation of this antibody in other pleural neoplasms is limited. The aim of this study was to determine the diagnostic value of D2-40 in segregation of malignant mesothelioma from other pleural or lung neoplasms. Sixty-seven cases, including 36 pleural malignant mesotheliomas, 15 solitary fibrous tumors, 13 pleomorphic carcinomas, and 3 synovial sarcomas, were immunohistochemically studied using a D2-40 monoclonal antibody. Twenty-five (21 epithelioid and 4 biphasic) of 36 (69%) malignant mesotheliomas and 2 of 15 (13%) solitary fibrous tumors were positive for D2-40. The difference of D2-40 positivity between these 2 types of tumor was significant (P<0.001). No D2-40 positivity was detected in pleomorphic carcinomas (n=13) or synovial sarcomas (n=3). These findings showed that D2-40 was frequently positive in malignant mesothelioma, but could also be positive in a small portion of solitary fibrous tumor. These results indicate that D2-40 is a valuable marker for malignant mesothelioma, but caution should be taken when evaluating D2-40-positive pleural spindle cell neoplasms in limited small biopsy specimens, especially when the differential diagnosis includes solitary fibrous tumor and malignant mesothelioma.
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Abstract
AIMS Tissue microarray (TMA) technology has been utilised for assessment of cancers including malignant pleural mesothelioma (MPM). Given the intralesional heterogeneity of MPM, it is questionable if TMAs can adequately represent MPMs. We here investigate the validity of TMAs for MPM. METHODS TMAs were constructed from at least five cores for each of 80 archival tumours processed by two centres between 1994 and 2009. The percentage of cases correctly subtyped on TMAs compared with whole sections, in relation to the number of cores analysed, was calculated. Immunohistochemical labelling for calretinin and D2-40 was performed on TMAs and whole sections. To evaluate the validity of quantitative immunohistochemistry, percentages of positive cells were recorded and two-way analysis of variance (ANOVA) performed. RESULTS Five cores were assessable for 91% of patients. Four cores were sufficient to reach concordance with the whole-section result in 98% of cases for calretinin and 99% for D2-40. The correlation of the quantitative scores between the whole section and TMA cores was statistically significant (D2-40, rho = 0.84, p < 2.2e-16; calretinin, rho = 0.65, p = 7.9e-11). Neither the origin nor age of the blocks affected the results. CONCLUSION If a minimum of four cores is used, TMA is an appropriate method for immunohistochemistry in MPM.
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Sawa Y. New trends in the study of podoplanin as a cell morphological regulator. JAPANESE DENTAL SCIENCE REVIEW 2010. [DOI: 10.1016/j.jdsr.2010.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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36
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Hanna A, Pang Y, Bedrossian CWM, Dejmek A, Michael CW. Podoplanin is a useful marker for identifying mesothelioma in malignant effusions. Diagn Cytopathol 2010; 38:264-9. [PMID: 20146302 DOI: 10.1002/dc.21340] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The diagnosis of malignant mesothelioma in serosal effusions continues to be a major challenge because some of its cytomorphological features closely resemble adenocarcinomas. Immunohistochemistry is a valuable tool in the differentiation of epithelioid mesothelioma from metastatic adenocarcinomas. However, no single antibody has demonstrated absolute sensitivity or specificity. In this study, we evaluated the value of immunostaining pattern for podoplanin to differentiate mesothelioma from adenocarcinomas of various origins.Cell blocks from previously collected paraffin-embedded cell blocks of 86 effusions (18 mesothelioma, 35 reactive mesothelium, 9 breast adenocarcinoma, 14 ovarian adenocarcinoma, and 10 lung adenocarcinoma) were retrieved from the file of the Department of Pathology at University of Michigan and Lund University in Sweden and were used for the study. Slides prepared from the cell blocks were stained for podoplanin. The percentage of immunostained cells was recorded as follows: 1+ (5-25%), 2+ (26-50%), and 3+ (>50%). A stain result involving <5% of cells was considered negative. The intensity of positive results was evaluated as strong, moderate, or weak.Podoplanin is expressed in 94% of malignant mesothelioma cases (17/18), 97% (30/31) of cases of reactive mesothelial, 0% of lung adenocarcinoma cases (0/9), 0% of breast adenocarcinoma (0/9), and 7% of ovarian adenocarcinoma (1/14). All positive cases of malignant mesothelioma and reactive mesothelium showed strong membranous reactivity to podoplanin. The one positive case of ovarian adenocarcinoma showed a weak membranous podoplanin immunostaining.On the basis of our results and published data, we believe that membranous podoplanin immunoreactivity, in conjunction with calretinin, would be more specific than CK5/6 and WT-1 in differentiating epithelioid malignant mesothelioma from adenocarcinoma of the lung, breast, and ovary.
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Affiliation(s)
- Atef Hanna
- Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109-0054, USA
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37
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Impact of podoplanin expression in oral squamous cell carcinoma: clinical and histopathologic correlations. Virchows Arch 2010; 456:473-82. [DOI: 10.1007/s00428-010-0915-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 03/02/2010] [Accepted: 03/29/2010] [Indexed: 01/22/2023]
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Klebe S, Brownlee NA, Mahar A, Burchette JL, Sporn TA, Vollmer RT, Roggli VL. Sarcomatoid mesothelioma: a clinical-pathologic correlation of 326 cases. Mod Pathol 2010; 23:470-9. [PMID: 20081811 DOI: 10.1038/modpathol.2009.180] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Sarcomatoid mesothelioma is the least common, but most aggressive of the three major histological types of mesotheliomas. This study comprises 326 cases of sarcomatoid mesotheliomas among 2000 consecutive malignant mesothelioma cases received in consultation (16%). Patients included 312 men (96%) and 14 women (4%), with a median age of 70 years (range 41-94 years). Most tumors were pleural (319; 98%), and 7 were peritoneal (2%). Some desmoplastic features were identified in 110 cases (34%), and 70 (21%) were classified as desmoplastic. Rare subtypes included two cases with a lymphohistiocytoid pattern (<1%) and eight heterologous mesotheliomas (2%). Labeling for cytokeratins (CKs) was observed in 261/280 cases (93%), and for calretinin and vimentin in 31 and 91%, respectively. Pleural plaques were present in 79% of cases for which information was available, and asbestosis was diagnosed in 34/127 cases (27%). Median survival was 3.5 months. Fiber analysis was performed in 61 cases. The median asbestos body count was 1640/g wet lung tissue (by light microscopy). Amosite fibers were the most commonly identified fibers using energy-dispersive X-ray analysis and were significantly higher in the sarcomatoid cases, as were uncoated fibers using scanning electron microscopy. This study represents the largest series of sarcomatoid and desmoplastic malignant mesotheliomas to date and confirms the diagnostic usefulness of CK immunohistochemistry. The relationship with asbestos exposure--particularly amosite--and an association with pleural plaques and less often asbestosis is confirmed.
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Affiliation(s)
- Sonja Klebe
- Department of Anatomical Pathology, Flinders University and Medical Centre, Adelaide, Australia.
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Deniz H, Kibar Y, Güldür ME, Bakır K. Is D2-40 a useful marker for distinguishing malignant mesothelioma from pulmonary adenocarcinoma and benign mesothelial proliferations? Pathol Res Pract 2009; 205:749-52. [DOI: 10.1016/j.prp.2009.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 05/26/2009] [Accepted: 06/05/2009] [Indexed: 10/20/2022]
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40
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Takeshima Y, Amatya VJ, Kushitani K, Kaneko M, Inai K. Value of immunohistochemistry in the differential diagnosis of pleural sarcomatoid mesothelioma from lung sarcomatoid carcinoma. Histopathology 2009; 54:667-76. [PMID: 19438742 DOI: 10.1111/j.1365-2559.2009.03298.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS The differential diagnosis of pleural sarcomatoid mesothelioma (SM) from lung sarcomatoid carcinoma (LSC) invading parietal pleura and chest wall is a challenging issue. The aim of this study was to identify useful antibodies that can be used for the differential diagnosis of pleural SM from LSC. METHODS AND RESULTS Forty-five cases of pleural SM and 27 cases of LSC were immunohistochemically analysed by using 15 commercially available antibodies, including D2-40 and antibodies to calretinin, thrombomodulin, Wilms' Tumour 1, carcinoembryonic antigen (CEA), Napsin A, thyroid transcription factor (TTF)-1, pan-cytokeratin, CAM5.2, epithelial membrane antigen, Ber-EP4, MOC-31, alpha-smooth muscle actin, h-caldesmon and desmin. The results revealed that D2-40 positivity was significantly higher in pleural SM (86.7%) than in LSC (25.9%). The positivity of the adenocarcinoma markers, including CEA, Napsin A, and TTF-1, was low even in LSC. CONCLUSIONS Evaluating the positivity and degree of staining of the well-known mesothelial marker D2-40 could be applied to differentiate pleural SM from the sarcomatoid component of LSC, in addition to assessing clinical and radiological information.
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Affiliation(s)
- Yukio Takeshima
- Department of Pathology, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan.
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Chirieac LR, Corson JM. Pathologic Evaluation of Malignant Pleural Mesothelioma. Semin Thorac Cardiovasc Surg 2009; 21:121-4. [DOI: 10.1053/j.semtcvs.2009.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2009] [Indexed: 11/11/2022]
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Takeshima Y, Inai K, Amatya VJ, Gemba K, Aoe K, Fujimoto N, Kato K, Kishimoto T. Accuracy of pathological diagnosis of mesothelioma cases in Japan: clinicopathological analysis of 382 cases. Lung Cancer 2009; 66:191-7. [PMID: 19232771 DOI: 10.1016/j.lungcan.2009.01.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Revised: 01/06/2009] [Accepted: 01/19/2009] [Indexed: 11/26/2022]
Abstract
Incidences of mesothelioma are on the rise in Japan. However, the accurate frequency of mesothelioma occurrence is still unknown. The aim of this study is to clarify the accuracy of pathological diagnosis of mesothelioma. Among the 2742 mesothelioma death cases extracted from the document "Vital Statistics of Japan" for 2003-2005, pathological materials were obtained for 382 cases. After these materials were reviewed and immunohistochemical analyses were conducted, mesothelioma was diagnosed by discussions based on clinical and radiological information. Sixty-five cases (17.0%) were categorized as "definitely not/unlikely" mesotheliomas, and 273 cases (71.5%) were categorized as "probable/definite" mesotheliomas. The percentage of "probable/definite" pleural and peritoneal mesothelioma cases in males was 74.3% and 87.5%, respectively, and that of pleural cases in females was 59.2%; however, the percentage of "probable/definite" peritoneal cases in females was only 22.2%. These results suggest that the diagnostic accuracy of mesothelioma is relatively low in females and in cases of peritoneal and sarcomatoid subtype mesotheliomas; furthermore, approximately 15% of cases of deaths due to mesothelioma in Japan are diagnostically suspicious.
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Affiliation(s)
- Yukio Takeshima
- Department of Pathology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
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Pelosi G, Sonzogni A, De Pas T, Galetta D, Veronesi G, Spaggiari L, Manzotti M, Fumagalli C, Bresaola E, Nappi O, Viale G, Rosai J. Review article: pulmonary sarcomatoid carcinomas: a practical overview. Int J Surg Pathol 2009; 18:103-20. [PMID: 19124452 DOI: 10.1177/1066896908330049] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pulmonary sarcomatoid carcinomas (PSCs) are currently defined as poorly differentiated non-small-cell carcinomas containing a component with sarcoma or sarcoma-like (spindle and/or giant cell) features. They consist of 5 major histological variants, namely pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. The segregation of PSCs into a distinct clinicopathologic entity seems justified on the basis of morphologic, behavioral, and genotypic/phenotypic attributes. As a group, PSCs generally run an aggressive clinical course and may cause major difficulties in the differential diagnosis with other primary and secondary malignancies of the lung. At present, PSCs are believed to represent a family of carcinomas "in transition," in which diverse pathways of clonal evolution account for histological differences of a common ancestor lesion. The sarcomatous or sarcomatoid component of these tumors is thought to derive from carcinoma cells during the progression of carcinogenesis through the activation of an epithelial-mesenchymal transition program leading to sarcomatous transformation or metaplasia (conversion paradigm). Conceivably, targeting the epithelial-mesenchymal transition program could become a valid therapeutic strategy for these life-threatening tumors, whose sensitivity to current medical manipulation is disappointing.
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Affiliation(s)
- Giuseppe Pelosi
- Division of Pathology and Laboratory Medicine, University of Milan School of Medicine, Milan.
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Abstract
D2-40 is a commercially available monoclonal antibody directed against human podoplanin, a transmembrane mucoprotein that is expressed in lymphatic endothelial cells. Since its introduction, D2-40 immunoexpression has been described in a variety of lymphovascular neoplasms including lymphangioma, Kaposi sarcoma, and hemangioendothelioma, as well as nonvascular neoplasms such as epithelioid mesothelioma, seminoma, and hemangioblastoma. More recently, D2-40 immunoexpression has been reported in primary adrenal cortical tumors, schwannomas, and adnexal tumors of the skin. This brief review provides an update on the ever-expanding proposed applications of D2-40 immunohistochemistry in surgical pathology.
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Kenmotsu H, Ishii G, Nagai K, Nakao M, Kawase A, Kojika M, Murata Y, Nishiwaki Y, Ochiai A. Pleomorphic carcinoma of the lung expressing podoplanin and calretinin. Pathol Int 2008; 58:771-4. [DOI: 10.1111/j.1440-1827.2008.02309.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Many centres are now seeing increasing numbers of patients with malignant mesothelioma. This presents pathologists involved in making the diagnosis with a number of problems, which can be divided into those encountered in making the distinction between mesothelioma and benign changes and those experienced in separating mesotheliomas from other types of epithelial and connective tissue tumours. Immunohistochemistry plays a major role in helping to make the diagnosis, but it should be interpreted with due regard to the clinical setting and radiological features, and with a knowledge of the wide morphological variations seen in mesothelioma. This review identifies some of these problems and addresses the uses and limitations of immunohistochemistry in different situations. It includes a discussion of some of the less common variants of mesothelioma and other pleural-based tumours that enter into the differential diagnosis.
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Affiliation(s)
- Bruce Addis
- Department of Cellular Pathology, Southampton University Hospitals NHS Trust, Southampton, UK.
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