The potential utility of GATA binding protein 3 for diagnosis of malignant pleural mesotheliomas

Prabhakaran, Sarita; Hocking, Ashleigh; Kim, Chankyung; Hussey, Matthew; Klebe, Sonja

doi:10.1016/j.humpath.2020.08.005

Cited by 24 publications

(22 citation statements)

References 31 publications

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“…GATA3 (GATA-3 binding protein) is a transcription factor that shows relatively strong and diffuse nuclear positivity in approximately 55% of mesotheliomas, including a high percentage of sarcomatoid and desmoplastic tumors, making GATA3 helpful in distinguishing reactive fibrous pleuritis (which is typically GATA3-negative) from sarcomatoid/desmoplastic mesothelioma 23,24,27 . As with all previous markers discussed, at least focal nuclear staining can be seen in many carcinoma subtypes (lung adenocarcinoma, 8%; gastric adenocarcinoma, 5%; pancreatic adenocarcinoma, 37%; lung squamous cell carcinoma, 6%), including pulmonary sarcomatoid carcinomas (15%) 24,27 …”

Section: Discussionmentioning

confidence: 96%

Immunohistochemical Pitfalls in Malignant Peritoneal Mesothelioma: A Case Report and Review for the General Pathologist

Stashek

Fanaroff

Burke

2022

AJSP: Reviews and Reports

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Malignant peritoneal mesothelioma is an aggressive malignancy that often mimics carcinomatosis both clinically and histologically, making definitive diagnosis challenging for the general pathologist. Many of the common immunohistochemical stains used to narrow the differential diagnosis show a lack of specificity, requiring a panel approach to ensure correct categorization. We report a case of epithelioid malignant peritoneal mesothelioma with diffuse and strong Ber-EP4 positivity and review some of the most commonly encountered pitfalls associated with immunohistochemical staining.

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Section: Discussionmentioning

confidence: 96%

Immunohistochemical Pitfalls in Malignant Peritoneal Mesothelioma: A Case Report and Review for the General Pathologist

Stashek

Fanaroff

Burke

2022

AJSP: Reviews and Reports

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“…Regarding GATA3, some authors have addressed the potential use of this antibody in the diagnosis of mesothelioma and have shown that in their experience, the sarcomatoid subtype yield more positive staining with up to 73%. 16 Terra et al 17 in a study of sarcomatoid mesothelioma and sarcomatoid carcinoma reported 98% positive staining for GATA3 in sarcomatoid mesothelioma and 47% in sarcomatoid carcinoma, whereas Berg and Churg 18 reported 19 cases (100%) positive diffuse staining with GATA3 and only 2 of 13 sarcomatoid carcinomas showed weak and patchy positive staining for GATA3. However, in our experience, GATA3 was seen positive in only 10 of 64 cases (15.6%), which is far below the percentage reported by others.…”

Section: Discussionmentioning

confidence: 98%

Sarcomatoid Mesothelioma: A Clinicopathological and Immunohistochemical Study of 64 Cases

2021

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Sixty-four cases of sarcomatoid pleural mesothelioma represent the basis of this study. The patients are 51 men and 13 women between the ages of 42 and 79 years, who presented with symptoms of chest pain, cough, and weight loss. Diagnostic imaging showed the presence of diffuse pleural thickening with encasement of the lung parenchyma in all the cases. All patients had surgical resection via extrapleural pneumonectomy. By immunohistochemistry, all cases were positive for cytokeratin AE1/AE3; however, reactivity with other markers including keratin 5/6, calretinin, and D2-40 was seen in different proportions, whereas a few cases showed positive staining for GATA3, WT1, and p40. All tumors were negative for carcinomatous epitopes (carcinoembryonic antigen, CD15, and TTF1). Our findings show that even though the use of immunohistochemical stains plays an important role in the final interpretation, the best results are accomplished by a global interpretation of clinical, radiographical, and immunohistochemical findings. It is also important to highlight that it does not seem to be a single immunohistochemical stain that is pathognomonic of sarcomatoid mesothelioma and that some other stains that are commonly used for other tumors may also show positive staining in a small percentage of sarcomatoid mesotheliomas.

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“…A few years ago, Berg and Churg reported that the detection of any positive staining for GATA3 was 100% sensitive and 85% specific for sarcomatoid/desmoplastic mesothelioma 28. Prabhakaran et al 29 and Terra et al 30 also noted that GATA3 was 73%–98% positive for sarcomatoid mesothelioma. However, our heterologous mesotheliomas were completely negative for GATA3, and this was negative in pulmonary osteosarcomas, too.…”

Section: Discussionmentioning

confidence: 99%

Malignant pleural mesothelioma with heterologous elements

et al. 2021

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AimsMalignant pleural mesothelioma with heterologous elements (such as osseous, cartilaginous or rhabdomyoblastic differentiation) is very rare. We tried to differentiate such mesothelioma cases from extraskeletal pleural osteosarcoma, which is very challenging.MethodsWe compared 10 malignant pleural mesotheliomas (three biphasic and seven sarcomatoid types) with two pleural osteosarcomas using clinicopathological and immunohistochemical methods, and also fluorescence in situ hybridisation (FISH) to examine for homozygous deletion of p16.ResultsThe median age was 72 years for mesotheliomas, and 69 years for osteosarcoma. For mesothelioma, eight cases were male and two were female. Growth was diffuse in all mesothelioma cases except case 10, where it was localised, as it was for the two osteosarcomas. Among mesothelioma cases, 80% displayed osteosarcomatous and 60% chondromatous elements, while 10% exhibited rhabdomyoblastic ones. Immunohistochemical labelling for calretinin and AE1/AE3 was present in 8/10 and 7/10 mesotheliomas, respectively, but in only one osteosarcoma. Loss of methylthioadenosine phosphorylase was seen in 5/7 mesotheliomas. FISH analysis revealed homozygous deletion of p16 in 5/8 mesothelioma and 2/2 osteosarcoma. Median survival was 6.5 months after biopsy or surgical operation in mesothelioma, and 12 months after operation in osteosarcoma.ConclusionsAlthough median survival was longer for osteosarcoma than for malignant mesothelioma, we could not differentiate mesothelioma from pleural osteosarcoma on the combined basis of clinicopathological and immunohistochemical data, and FISH analysis. However, diffuse growth was more frequent in mesothelioma than in osteosarcoma.

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The potential utility of GATA binding protein 3 for diagnosis of malignant pleural mesotheliomas

Cited by 24 publications

References 31 publications

Immunohistochemical Pitfalls in Malignant Peritoneal Mesothelioma: A Case Report and Review for the General Pathologist

Immunohistochemical Pitfalls in Malignant Peritoneal Mesothelioma: A Case Report and Review for the General Pathologist

Sarcomatoid Mesothelioma: A Clinicopathological and Immunohistochemical Study of 64 Cases

Malignant pleural mesothelioma with heterologous elements

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