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Updated: Oct 25, 2025

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Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
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Malignant pleural mesothelioma with heterologous elements
Toshiaki Kawai1, Reishi Seki2, Kuniharu Miyajima3
1Toda Central Medical Laboratory, Toda, Japan t_kawai@tmg.or.jp.
Journal of Clinical Pathology
|August 11, 2021
Summary
Differentiating malignant pleural mesothelioma with heterologous elements from pleural osteosarcoma is challenging. Clinicopathological, immunohistochemical, and FISH analyses did not reliably distinguish between these rare pleural tumors.
Area of Science:
- Oncology
- Pathology
- Thoracic Surgery
Background:
- Malignant pleural mesothelioma with heterologous elements is rare.
- Distinguishing these mesotheliomas from extraskeletal pleural osteosarcoma poses diagnostic challenges.
Purpose of the Study:
- To differentiate malignant pleural mesotheliomas with heterologous elements from pleural osteosarcomas.
- To evaluate clinicopathological, immunohistochemical, and fluorescence in situ hybridization (FISH) findings.
Main Methods:
- Comparison of 10 malignant pleural mesotheliomas and 2 pleural osteosarcomas.
- Utilized clinicopathological data, immunohistochemistry (calretinin, AE1/AE3, methylthioadenosine phosphorylase), and FISH for p16 deletion.
- Assessed tumor growth patterns (diffuse vs. localized).
Main Results:
- Median survival was shorter for mesothelioma (6.5 months) than osteosarcoma (12 months).
- Mesothelioma cases frequently showed osteosarcomatous (80%) and chondromatous (60%) elements.
- Immunohistochemistry and FISH analysis showed overlapping results, with p16 homozygous deletion in 5/8 mesotheliomas and 2/2 osteosarcomas.
Conclusions:
- Clinicopathological, immunohistochemical, and FISH analyses were insufficient to reliably differentiate mesothelioma from pleural osteosarcoma.
- Diffuse growth pattern was more characteristic of malignant pleural mesothelioma.
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