Pleural neoplastic pathology

Karpathiou, Georgia; Stefanou, Dimitrios; Froudarakis, Marios

doi:10.1016/j.rmed.2015.05.014

Cited by 58 publications

(58 citation statements)

References 87 publications

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“…The same cases posed difficulties even during the definite diagnosis. It is true that regarding the differential diagnosis of MPM from a reactive condition, either mesothelial hyperplasia or fibrosing pleuritis, fat invasion is the most important criterion, along with nodular architecture and prominent cellularity invading vertically or without organization the whole thickness of the fibrosing pleura [6] . Recently, p16 FISH and BAP1 immunohistochemistry have been proven useful for this differentiation [6] .…”

Section: Resultsmentioning

confidence: 99%

“…It is true that regarding the differential diagnosis of MPM from a reactive condition, either mesothelial hyperplasia or fibrosing pleuritis, fat invasion is the most important criterion, along with nodular architecture and prominent cellularity invading vertically or without organization the whole thickness of the fibrosing pleura [6] . Recently, p16 FISH and BAP1 immunohistochemistry have been proven useful for this differentiation [6] . Thus, during frozen section, moderately cellular lesions without prominent invasion -defined as fat invasion or haphazardly invading cellular proliferation -, are those to pose most of the difficulties.…”

Section: Resultsmentioning

confidence: 99%

“…As for the definitive section diagnosis, this is based on standard histological criteria [6] . Immunohistochemical study was generally adapted to each case but the antibodies most often used were: CK5/6 (D5/16 B4; Dako, Courtaboeuf, France, 1/600), Calretinin (DC8; Invitrogen, 1/200), D2-40 (Dako), HBME1 (HBME1; Dako, 1/150), WT1 (6F-H2; BD Biosciences), ACE (II-7; Dako, 1/400), CD15 (Carb-3; Dako, 1/200), BerEP4 (Ber-EP4; Dako, 1/50), TTF-1 (8G7G3/1; Dako, 1/50), p40 (RP163; Clinisciences, Nanterre, France, 1/75), AE1/AE3 (AE1/AE3; Dako, 1/200), and KL1 (KL1; Beckman-Coulter, Villepinte, France, 1/400).…”

Section: Histological Evaluationmentioning

confidence: 99%

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Frozen Sections in Pleural Pathology: A Valuable Tool

Karpathiou

Froudarakis²,

Forest³

et al. 2017

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Background: Knowledge of pleural malignancy can lead to immediate pleurodesis during thoracoscopy. However, the accuracy of pleural frozen sections is largely unknown. Objectives: To investigate the accuracy of frozen sections in pleural tumor pathology. Methods: A total of 156 frozen pleural sections performed with the question of malignancy were retrospectively reviewed. The original frozen sections were compared to the permanent section slides which were considered as the gold standard. The influence of the following parameters on the frozen section response was evaluated: specimen size, clinical information, as well as the processing by a specialized pulmonary pathologist or not. The reasons of discrepancies were categorized as sampling errors or interpretation errors. Results: Frozen sections made up 16.4% of 951 pleural biopsies performed in the same time period. Accurate diagnosis was feasible in 92.3% of the cases. There were 7 (4.5%) deferred (inconclusive) cases and 5 (3.2%) discrepant cases. Sensitivity of the method was 96.26%, specificity 97.87%, the positive predictive value was 99.04%, and the negative predictive value was 92%. There was no association between the responses given during frozen section and specimen size, clinical information, or the evaluation by a specialized pulmonary pathologist. Four of the 12 cases were sampling errors, while 8 cases were interpretation errors mostly made in the absence of fat tissue invasion. Thus, paucicellular lesions without prominent invasion - fat invasion or haphazardly invading cellular proliferation - were those posing most of the difficulties during frozen section. Conclusions: Frozen sections are a highly accurate tool in pleural pathology. Thus, they can be used when an immediate pleurodesis is requested.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Histological Evaluationmentioning

confidence: 99%

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Frozen Sections in Pleural Pathology: A Valuable Tool

Karpathiou

Froudarakis²,

Forest³

et al. 2017

Respiration

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“…The diagnosis of lung adenocarcinoma in MPE has been discussed in the literature (23,24). MPE samples are now commonly used for diagnosis and molecular testing of NSCLC patients at stage IV.…”

Section: Discussionmentioning

confidence: 99%

ALK gene expression status in pleural effusion predicts tumor responsiveness to crizotinib in Chinese patients with lung adenocarcinoma

Wang

Han

et al. 2016

Chinese Journal of Cancer Research

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ObjectiveThe relationship between anaplastic lymphoma kinase (ALK) expression in malignant pleural effusion (MPE) samples detected only by Ventana immunohistochemistry (IHC) ALK (D5F3) and the efficacy of ALK-tyrosine kinase inhibitor therapy is uncertain. MethodsVentana anti-ALK (D5F3) rabbit monoclonal primary antibody testing was performed on 313 cell blocks of MPE samples from Chinese patients with advanced lung adenocarcinoma, and fluorescence in situ hybridization (FISH) was used to verify the ALK gene status in Ventana IHC ALK (D5F3)-positive samples. The follow-up clinical data on patients who received crizotinib treatment were recorded. ResultsOf the 313 MPE samples, 27 (8.6%) were confirmed as ALK expression-positive, and the Ventana IHC ALK (D5F3)-positive rate was 17.3% (27/156) in wild-type epidermal growth factor receptor (EGFR) MPE samples. Twenty-three of the 27 IHC ALK (D5F3)-positive samples were positive by FISH. Of the 11 Ventana IHC ALK (D5F3)-positive patients who received crizotinib therapy, 2 patients had complete response (CR), 5 had partial response (PR) and 3 had stable disease (SD). ConclusionsThe ALK gene expression status detected by the Ventana IHC ALK (D5F3) platform in MPE samples may predict tumor responsiveness to crizotinib in Chinese patients with advanced lung adenocarcinoma.

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“…1 Malignant pleural effusion (MPE) occurs in approximately 40% of advanced NSCLC patients and more frequently in those with lung adenocarcinoma which is more likely to arise in lung periphery invading the pleura. 2,3 Patients with an MPE are grouped as stage IV, M1a category, in the TNM classification of NSCLC, as the overall survival (OS) of this patient population is only 8.5 months. 4 Among lung cancer patients, lung adenocarcinoma is the main cause of MPE (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Novel insights into the systemic treatment of lung cancer malignant pleural effusion

Tissot

Gay

Brun

et al. 2019

Clinical Respiratory J

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Lung cancer is the most common fatal malignancy worldwide. Approximately 75% of non‐small‐cell lung cancer (NSCLC) patients are diagnosed at an advanced or a metastatic stage. Since 2007, NSCLC patients with malignant pleural effusion (MPE) are staged as M1 disease. During the last decades, chemotherapeutic agents failed to offer a significant improvement of survival in patients with metastatic disease. The current review aims to summarize the actual situation of the recently developed therapies in patients with lung cancer and MPE.

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Pleural neoplastic pathology

Abstract: The basic pathological, immunohistochemical and molecular characteristics of these entities are provided in the current review, along with their differential diagnosis.

Cited by 58 publications

References 87 publications

Frozen Sections in Pleural Pathology: A Valuable Tool

Frozen Sections in Pleural Pathology: A Valuable Tool

ALK gene expression status in pleural effusion predicts tumor responsiveness to crizotinib in Chinese patients with lung adenocarcinoma

Novel insights into the systemic treatment of lung cancer malignant pleural effusion

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