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Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines

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Malignant Mesothelioma Diagnosis.

Qudsia Arif¹, Aliya N Husain¹

¹From the Department of Pathology, University of Chicago, Chicago, Illinois.

Archives of Pathology & Laboratory Medicine

|August 1, 2015

Summary

Diagnosing malignant mesothelioma can be challenging. Immunohistochemical markers like WT-1 and p16 deletion are crucial for accurate identification, distinguishing it from benign conditions.

Area of Science:

Pathology
Oncology
Genetics

Background:

Malignant mesothelioma is a rare pleural tumor that often mimics benign mesothelial lesions, carcinomas, and sarcomas.
Accurate diagnosis is challenging for pathologists due to overlapping features.

Purpose of the Study:

To provide an update on diagnostic markers for malignant mesothelioma.
To highlight immunohistochemical, cytogenetic, and molecular markers.

Main Methods:

Review of peer-reviewed publications, textbooks, and consensus reports.
Correlation of histologic findings with clinical and radiologic features.

Main Results:

Recommended markers include calretinin, WT-1, cytokeratin 5/6, and D2-40 (podoplanin).

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Using at least two mesothelial and two carcinoma markers with >80% sensitivity/specificity is advised.

p16 deletion is a strong indicator of mesothelioma, found in up to 100% of sarcomatoid types and 70% of epithelioid types, and absent in benign lesions.

Pleomorphic histologic patterns (>10% tumor) and high nuclear grade indicate aggressive behavior and poor prognosis.

Conclusions:

Histologic findings must be correlated with clinical and radiologic data.
Specific markers (calretinin, WT-1, CK5/6, D2-40) and p16 deletion aid diagnosis.
Histologic patterns and nuclear grade are prognostic indicators for malignant mesothelioma.