Progression of mesothelioma in situ to invasive disease 4 years and 10 months after initial diagnosis

Klebe, Sonja

doi:10.1016/j.pathol.2021.06.124

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…Recently, whole-exome sequencing confirmed that mesothelioma in situ development is associated with BAP1 somatic mutations/deletions, suggesting that BAP1 mutations/deletions represent a very early event in the development of malignant mesothelioma ( 3 ). Recently, new diagnostic tools, such as radiogenomics, have helped identify the potential correlation between imaging findings and tumour genotype.…”

Section: Discussionmentioning

confidence: 99%

“…Cases with shorter latency have been reported, and there may be cases with earlier and shorter asbestos exposures that have not been recognised because of the lack of an accurate assessment of asbestos exposure. Referring to short latency, mesothelioma is now diagnosed earlier via cytology, and non-invasive forms have been identified, such as in situ mesothelioma, which may affect the possibility of early diagnosis ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

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Case report: Mesothelioma and BAP1 tumor predisposition syndrome: Implications for public health

et al. 2022

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BRCA-1 associated protein 1 (BAP1) tumour predisposition syndrome (TPDS) is a hereditary condition characterised by germline mutation of the tumour suppressor BAP1. This disorder is associated with the development of various benign and malignant tumours, mainly involving the skin, eyes, kidneys, and mesothelium. In this article, we report the case of a man recruited through the Apulia (Southern Italy) Mesothelioma Regional Operational Centre of the National Register of Mesotheliomas, who suffered from uveal melanoma, renal cancer, and mesothelioma, and a familial cluster of BAP1 germline mutations demonstrated by molecular analyses. The family members of the proband developed multiple malignancies. As tumours arising in this context have specific peculiarities in terms of clinical behaviour, identification of this condition through appropriate genetic counselling should be considered for adequate primary, secondary, and tertiary prevention measures for offspring.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case report: Mesothelioma and BAP1 tumor predisposition syndrome: Implications for public health

et al. 2022

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“…We have presented a case of MIS that showed obviously malignant mesothelial cells based on cytology of pleural effusion. Based on our search of the literature, 17 cases of pleural MIS have been reported (Table I) (2,(5)(6)(7)(8)(9)(10)(11)(12). According to available data from previous reports, MIS was confirmed only in 8 cases before progression to mesothelioma (2,5,6,8,10,11).…”

Section: Discussionmentioning

confidence: 99%

“…Based on our search of the literature, 17 cases of pleural MIS have been reported (Table I) (2,(5)(6)(7)(8)(9)(10)(11)(12). According to available data from previous reports, MIS was confirmed only in 8 cases before progression to mesothelioma (2,5,6,8,10,11). It is difficult to suspect MIS at the time of sampling due to unremarkable clinical findings including symptoms, serum tumor markers, radiology, and even pathology.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of malignant pleural effusion for early cytological diagnosis of mesothelioma in situ: A case report

et al. 2022

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Mesothelioma in situ (MIS) is defined as a preinvasive mesothelioma that forms a single layer of mild atypical mesothelial cells lining on the serosa surface of pleura. The atypical mesothelial cells present loss of BRCA-1 associated protein-1 (BAP-1) and/or methylthioadenosine phosphorylase as examined by immunohistochemistry (IHC) and/or homozygous deletion of cyclin-dependent kinase inhibitor 2A/p16 as examined by fluorescence in situ hybridization. It is difficult to diagnose because of the unremarkable clinical findings except for pleural effusion. The present report describes a case in which MIS was diagnosed at the time of sampling due to the presence of clearly malignant mesothelial cells in the pleural fluid. In 2016, a 74-year-old man with a history of past exposure to asbestos was admitted to Ibaraki Higashi National Hospital (Tokai-mura, Japan) with dyspnea. Chest CT indicated only right pleural effusion. Malignant mesothelial cells were suspected in a cell block made using pleural effusion; therefore, right pleural biopsy was performed. Pathologically, there was proliferation of mesothelial cells with mild atypia that formed a single-flat layer on the pleural surface; however, there was no invasion. Furthermore, IHC revealed loss of BAP-1 in cells from the biopsied pleura and pleural effusion. MIS was suspected at the time; however, the patient arbitrarily quit his medical check-ups. After 44 months, the patient was readmitted to our hospital complaining of dyspnea. CT indicated a large right pleural mass. A specimen of the mass obtained via CT-guided needle biopsy revealed malignant mesothelioma. The patient continued to deteriorate and eventually died. This case indicated that pleural effusion could be used to demonstrate overtly malignant mesothelial cells and diagnose MIS at the time of sampling. To the best of our knowledge, this is first report of MIS with overtly malignant mesothelial cells in pleural effusion. Pleural effusion may serve an important role in MIS diagnosis.

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“…Then, two cases of mesothelial lesions characterized by only surface cells and no invasion (or minute invasive foci) but harboring the aforementioned molecular abnormalities were suggested as being true mesothelioma in situ cases [87]. Similarly, another case of proposed mesothelioma in situ [89] progressed to invasive disease almost five years later [90]. Following their initial observation, a group of experts in mesothelial pathology gathered another nine cases diagnosed with the following strict criteria: single layer of surface mesothelial cells with lost BAP1 expression, no evidence of invasive tumor by imaging techniques or during visual inspection of the serosal cavity, and no invasive mesothelioma diagnosed for at least 12 months after initial biopsy to avoid initial misdiagnoses [91].…”

Section: Non-specific Pleuritismentioning

confidence: 99%

Inflammation of the Pleural Cavity: A Review on Pathogenesis, Diagnosis and Implications in Tumor Pathophysiology

Karpathiou

Péoc’h

Sundaralingam

et al. 2022

Cancers

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Pleural effusions are a common respiratory condition with many etiologies. Nonmalignant etiologies explain most pleural effusions and despite being nonmalignant, they can be associated with poor survival; thus, it is important to understand their pathophysiology. Furthermore, diagnosing a benign pleural pathology always harbors the uncertainty of a false-negative diagnosis for physicians and pathologists, especially for the group of non-specific pleuritis. This review aims to present the role of the inflammation in the development of benign pleural effusions, with a special interest in their pathophysiology and their association with malignancy.

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Progression of mesothelioma in situ to invasive disease 4 years and 10 months after initial diagnosis

Cited by 8 publications

References 6 publications

Case report: Mesothelioma and BAP1 tumor predisposition syndrome: Implications for public health

Case report: Mesothelioma and BAP1 tumor predisposition syndrome: Implications for public health

Usefulness of malignant pleural effusion for early cytological diagnosis of mesothelioma in situ: A case report

Inflammation of the Pleural Cavity: A Review on Pathogenesis, Diagnosis and Implications in Tumor Pathophysiology

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