Sarcomatoid Mesothelioma: A Clinicopathological and Immunohistochemical Study of 64 Cases

Oramas, Diana M.; Zaleski, Michael; Moran, César A.

doi:10.1177/10668969211014256

Cited by 9 publications

(8 citation statements)

References 20 publications

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“…Sarcomatoid mesotheliomas are composed of proliferating spindles, elongated cells with fusiform nuclei, and inconspicuous nucleoli with variable atypia arranged haphazardly in a fascicular manner. In some cases, spindle cells alternate with areas of hyalinization, whereas in others, areas of necrosis can be present 29. Desmoplastic mesotheliomas are a variant of sarcomatoid mesothelioma, in which the spindle cells usually have mild atypia and are arranged haphazardly, in a hypocellular “patternless” pattern immersed in a dense, hyalinized stroma 30–32…”

Section: Pathologymentioning

confidence: 99%

Pericardial Mesotheliomas

Arrossi¹

2023

Advances in Anatomic Pathology

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Primary pericardial mesothelioma (PM) is a rare tumor arising from the mesothelial cells of the pericardium. It has an incidence of <0.05% and comprises <2% of all mesotheliomas; however, it is the most common primary malignancy of the pericardium. PM should be distinguished from secondary involvement by the spread of pleural mesothelioma or metastases, which are more common. Although data are controversial, the association between asbestos exposure and PM is less documented than that with other mesotheliomas. Late clinical presentation is common. Symptoms may be nonspecific but are usually related to pericardial constriction or cardiac tamponade, and diagnosis can be challenging usually requiring multiple imaging modalities. Echocardiography, computed tomography, and cardiac magnetic resonance demonstrate heterogeneously enhancing thickened pericardium, usually encasing the heart, with findings of constrictive physiology. Tissue sampling is essential for diagnosis. Histologically, similar to mesotheliomas elsewhere in the body, PM is classified as epithelioid, sarcomatoid, or biphasic, with the biphasic type being the most common. Combined with morphologic assessment, the use of immunohistochemistry and other ancillary studies is helpful for distinguishing mesotheliomas from benign proliferative processes and other neoplastic processes. The prognosis of PM is poor with about 22% 1-year survival. Unfortunately, the rarity of PM poses limitations for comprehensive and prospective studies to gain further insight into the pathobiology, diagnosis, and treatment of PM.

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Section: Pathologymentioning

confidence: 99%

Pericardial Mesotheliomas

Arrossi¹

2023

Advances in Anatomic Pathology

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“…Immunochemical profile of sarcomatoid mesothelioma is different from the epithelioid. Sarcomatoid mesotheliomas are at least focally positive for cytokeratins AE1/AE, pan-cytokeratin (OSCAR), and anti-cytokeratin clone 1(KL1), as well as cytokeratin CAM5.2 [62,68]. But sarcomatoid mesotheliomas can be cytokeratin-negative.…”

Section: Peritoneal Well-differentiated Papillary Mesothelial Tumor H...mentioning

confidence: 99%

“…But sarcomatoid mesotheliomas can be cytokeratin-negative. Sarcomatoid mesotheliomas are positive for mesothelial markers such as calretinin, WT1, and D2-40 in limited cases [62,68]. Sarcomatoid mesotheliomas are often vimentin-positive, whereas epithelioid mesotheliomas are often negative to vimentin.…”

Section: Peritoneal Well-differentiated Papillary Mesothelial Tumor H...mentioning

confidence: 99%

Mesothelioma: Overview of Technical, Immunochemical and Pathomorphological Diagnosing Aspects

Minajeva¹,

Saranova²

2022

Mesothelioma - Diagnostics, Treatment and Basic Research

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For the clinicians with non-pathology background, first encountering the patients with pleural or peritoneal effusions, mesothelioma is only one statistically rare but clinically significant option of many differential diagnoses. This review aims to help the clinicians and broad life science audiences to understand step by step the possibilities and shortcomings of pathological diagnosing of mesothelioma, including the basic technical requirements. The first cytomorphology evaluation of pleural and peritoneal effusions in routinely stained smears enables in most cases only to identify cells suspicious for malignancy. The recent guidelines of epithelioid mesothelioma cytologic diagnosis and reporting emphasize immunochemistry (IC) in the cell blocks is mandatory whenever a diagnosis of malignancy is clinically entertained and/or cytologically suspected. The IC workup is challenging, since there is no fixed antibody panel, but multiple questions must be solved, such as 1) confirm the mesothelial or epithelial origin of isolated atypical cells and cell clusters; 2) delineate their benign or malignant nature; and 3) discriminate mesothelioma from other malignancies and metastatic disease. The rationale of the most widely clinically used IC markers is given and illustrated by the examples. The final confirmation of mesothelioma diagnosis and establishing its subtype and grade is possible only in the histological samples.

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“…By definition, these tumors are characterized by the presence of spindle cellular proliferation with elongated nuclei and inconspicuous nucleoli. More recently, Oramas et al 21 reported 64 sarcomatoid mesotheliomas from patients who had extrapleural pneumonectomies and identified that in ~40% of the cases there was a small (< 10% of the total tumor burden) epithelioid component. The authors also noticed that nuclear atypia ranged from moderate to severe and that mitotic activity although present was not markedly increased.…”

Section: Sarcomatoid Mesotheliomamentioning

confidence: 99%

“…In contrast, reports of low survival rates in patients with sarcomatoid mesotheliomas have been reported in series exclusively with that type of mesothelioma with fatal outcomes in a period of 3 years. 21 Based on the different points of view regarding the clinical outcome and treatment options, it is possible that the best results are obtained in patients with good performance, epithelioid mesothelioma subtype without nodal disease, early pathologic stage, and treated with surgery and adjuvant or neoadjuvant therapy.…”

Section: Treatment and Clinical Outcomementioning

confidence: 99%

Pleural Mesothelioma: Current Practice and Approach

Lenskaya

Moran

2022

Advances in Anatomic Pathology

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Pleural mesotheliomas represent one of the most common diagnostic challenges in thoracic pathology. The diagnosis of pleural mesothelioma weighs heavily on clinical and radiologic information. In addition, in the past, before the era of immunohistochemistry, the diagnosis was aided with the use of special histochemical stains—PAS, D-PAS, and mucicarmine, which now very much have been replaced by immunohistochemical stains. In the era of immunohistochemistry, a combination of carcinomatous epitopes and positive mesothelioma markers has become paramount in the diagnosis of mesothelioma, and more recently the use of molecular techniques has become another ancillary tool in supporting such a diagnosis. At the same time, the treatment and clinical outcome of these patients may in some measure be determined by the histopathological features of the tumor and one that also over the years has changed from a palliative type to surgery, chemotherapy, radiotherapy, or a combination of these types. The histopathological growth patterns of mesothelioma are also wide, and in some cases may mimic other tumors that may be primary or metastatic to the pleura. Therefore, the assessment of the diagnosis of mesothelioma is one that requires a global view of the different factors including clinical, radiologic, pathologic—including immunohistochemistry and molecular diagnosis.

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Sarcomatoid Mesothelioma: A Clinicopathological and Immunohistochemical Study of 64 Cases

Cited by 9 publications

References 20 publications

Pericardial Mesotheliomas

Pericardial Mesotheliomas

Mesothelioma: Overview of Technical, Immunochemical and Pathomorphological Diagnosing Aspects

Pleural Mesothelioma: Current Practice and Approach

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