Related Experiment Video
Updated: Jun 2, 2026
Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Pathohistological diagnosis and differential diagnosis
Iris Tischoff1, Matthias Neid, Volker Neumann
1Ruhr-Universität Bochum, BG Kliniken Bergmannsheil, Bürke-de-la-Camp Platz 1, Bochum, Germany.
Abstract:
Malignant mesothelioma is a rare aggressive tumour arising from mesothelial cells of the pleural and peritoneal cavity including pericardium and tunica vaginalis testis. Malignant mesothelioma occurs predominantly in men (>90%). Asbestos exposure is the best known and evaluated risk factor with a long latency period between exposure and onset of malignant mesothelioma ranging from 15 to 60 years. Exposure to erionite leads to higher incidences of mesothelioma and play an important role in environmental exposure (Turkey). Other possible risk factors are radiation, recurrent pleuritis/peritonitis and simian virus 40 (SV 40).Malignant pleural mesothelioma is most common, whereas malignant peritoneal mesothelioma accounts only for 6-10%. Infrequent sites of origin are the pericardium and tunica vaginalis in 1-2%.Malignant mesothelioma shows either diffuse growth pattern or occurs as a localised tumour mass. Diffuse type represents an aggressive tumour with poor prognosis and is incurable in most cases.According to the WHO classification, three histological subtypes are distinguished: epithelioid, sarcomatoid and biphasic malignant mesothelioma.Rare variants are desmoplastic type, a subtype of sarcomatoid mesothelioma, undifferentiated type and deciduoid type. Epithelioid type is the most frequent one, but biphasic malignant mesothelioma occurs in 30%. Pure sarcomatoid or biphasic type is seen less frequently in malignant peritoneal mesothelioma than in its pleural counterpart.Well-differentiated papillary mesothelioma is a generally non-invasive mesothelioma with low malignant potential that arises mostly in females in the peritoneal cavity. Histological type is an important prognostic marker. Longest survival is seen in patients with epithelioid malignant mesothelioma. Sarcomatoid subtype has the worst prognosis.Malignant mesothelioma shows macroscopical and microscopical similarities to benign lesions and other malignancies. Therefore, reactive mesothelial proliferations on the one hand and secondary tumours resembling mesothelial cells as well as benign or rare mesothelial tumours on the other hand have to be distinguished. Additional immunohistochemistry is essential in histopathological assessment using a marker panel of antibodies.
Insights
Malignant mesothelioma is a rare, aggressive cancer primarily linked to asbestos exposure. Histological type significantly impacts prognosis, with epithelioid subtypes offering the best survival rates.
Area of Science:
- Oncology
- Pathology
Background:
- Malignant mesothelioma is a rare, aggressive neoplasm originating from mesothelial cells.
- It predominantly affects men, with asbestos exposure being the primary risk factor, characterized by a long latency period.
Purpose of the Study:
- To review the epidemiology, risk factors, classification, and diagnostic challenges of malignant mesothelioma.
- To highlight the prognostic significance of histological subtypes.
Main Methods:
- Review of existing literature on malignant mesothelioma.
- Analysis of epidemiological data, risk factors, and histological classifications.
- Discussion of diagnostic considerations, including differentiation from benign lesions and other malignancies.
Main Results:
- Malignant mesothelioma most commonly affects the pleura, with peritoneal, pericardial, and testicular involvement being less frequent.
- Histological subtypes include epithelioid, sarcomatoid, and biphasic, with epithelioid generally having a better prognosis than sarcomatoid.
- Well-differentiated papillary mesothelioma is a distinct, less aggressive variant, often seen in females.
Conclusions:
- Accurate histopathological assessment using immunohistochemistry is crucial for diagnosing malignant mesothelioma and distinguishing it from other conditions.
- Histological subtype is a key determinant of patient prognosis.
- Understanding risk factors like asbestos and erionite exposure is vital for prevention and early detection efforts.
Related Concept Videos
01:26Differential Staining Technique
01:25Introduction to Language of Pathophysiology l
01:28Methods of Classification and Identification
01:03Fixation and Sectioning
The simplest type of preparation is the wet mount, in which the specimen is placed in a drop of liquid on the slide. A liquid specimen can be directly deposited on the slide using a dropper. Solid specimens, such as skin scraping, can be placed on the slide before adding a drop of liquid to prepare the wet mount. Sometimes the liquid is simply water, but stains are often added...
01:26Phase Contrast and Differential Interference Contrast Microscopy
In-phase-contrast microscopes, interference between light directly passing through a cell and light refracted by cellular components is used to create high-contrast, high-resolution images without staining. It is the oldest and simplest type of microscope that creates an image by altering the wavelengths of light rays passing through the specimen. Altered wavelength paths are created using an annular stop in the condenser. The annular stop produces a hollow cone of...