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Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
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Malignant pleural mesothelioma with heterologous elements.

Toshiaki Kawai1, Reishi Seki2, Kuniharu Miyajima3

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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.

Keywords:
fishimmunohistochemistrypleura

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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.