Ultrastructural diagnosis of epithelial malignant mesothelioma

Tr, Burns; Sd, Greenberg; Ml, Mace; Eh, Johnson

doi:10.1002/1097-0142(19851015)56:8<2036::aid-cncr2820560825>3.0.co;2-2

Cited by 48 publications

(7 citation statements)

References 7 publications

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“…MM have a length/diameter ratio of 11.44 compared with adenocarcinomas, which have an average length/diameter ratio of 5.39. They concluded that a length/diameter ratio greater than 11 is highly suggestive of MM [20]. In our case, the length/diameter ratio was 15.72, confirming the diagnosis of MM.…”

Section: Discussionsupporting

confidence: 82%

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Soft Tissue Metastasis as Initial Manifestation of Pleural Malignant Mesothelioma

Laurini¹,

Castiglioni²,

Elsner³

et al. 1999

Int J Surg Pathol

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Distant metastases of pleural malignant mesothelioma (MM) are infrequent. We report a case of MM that presented as a skeletal muscle metastasis. This type of presentation has not been previously reported. A 38-year-old male complained about a mass in his right forearm. The tumor showed the histologic pattern, immunohistochemical phenotype, and ultrastructural features of an MM. In the clinical work-up, the x-ray film and computed tomography scan demonstrated pleural effusion and diffuse pleural thickening in the right hemithorax. The pleural biopsy showed an epithelial MM. The patient died from local progression of the disease 6 months after the diagnosis. No other distant metastases were clinically evident. Our case shows the importance of including MM in the differential diagnosis of metastatic neoplasms in skeletal muscle and the usefulness of ancillary techniques in the diagnosis of mesothelial neoplasms. Int J Surg Pathol 7(1): [39][40][41][42][43][44] 1999 Pleural malignant mesothelioma (MM) usually presents with chest pain and pleural effusion. Chest roentgenograms and computed tomography (CT) scans show diffuse and irregular pleural thickening in the affected hemithorax. The tumor has a locally aggressive behavior, which accounts for most of its morbidity and mortality. Autopsy studies have revealed the presence of distant metastases, although clinically evident metastases are rare manifestations of this neoplasm [1].We report a metastatic MM presenting as a skeletal muscle mass in a patient without a previously diagnosed pleural tumor. This type of pre-

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Section: Discussionsupporting

confidence: 82%

“…Warhol et al compared the different EM findings of MM and concluded that only the length and number of microvilli are helpful in the differential diagnosis with metastatic adenocarcinomas [19]. Burns [20]. MM have a length/diameter ratio of 11.44 compared with adenocarcinomas, which have an average length/diameter ratio of 5.39.…”

Section: Discussionmentioning

confidence: 99%

Soft Tissue Metastasis as Initial Manifestation of Pleural Malignant Mesothelioma

Laurini¹,

Castiglioni²,

Elsner³

et al. 1999

Int J Surg Pathol

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“…The use of electron microscopy in the diagnosis of mesothelioma has been limited by optimal fresh tissue availability and is now largely replaced by immunohistochemistry. Ultrastructural studies have greatest utility in distinguishing adenocarcinoma from epithelial mesothelioma 113…”

Section: Electron Microscopy Of Mesotheliomamentioning

confidence: 99%

Pathology of malignant mesothelioma

1997

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The diagnosis of malignant mesothelioma can pose several problems to the surgical pathologist. First, the morphological appearances of the tumour are known to be diverse with mimicry of a range of both reactive and neoplastic conditions. Second, due to the relative inaccessibility of the serosa, biopsy material is often scanty and fragmentary, producing a plethora of interpretive ambiguities. Third, adjunct techniques such as mucin histochemistry and immunohistochemistry, whilst useful in excluding malignant mesothelioma have little role in confirming the diagnosis. The accurate diagnosis of diffuse malignant mesothelioma is important for two reasons: (1) In relation to prognosis as it has an almost invariable fatal outcome, which contrasts with the other mesothelial neoplasms such as the benign adenomatoid tumour and the borderline malignant tumours, namely the well-differentiated papillary mesothelioma and multicystic mesothelioma; (2) In relation to occupational-related compensation claims following asbestos exposure. This review summarizes the aetiology of asbestos-induced neoplasia, possible mechanisms of tumour development and highlights potential diagnostic pitfalls.

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“…In an attempt to establish objective morphometric criteria for diagnosis, Warhol et al concluded that among several features examined, only microvillous length and quantity of tonofilaments are helpful 20 . Further studies have confirmed these findings 21 .…”

Section: Discussionmentioning

confidence: 68%

Prognostic value of high serum levels of CA‐125 in malignant secretory peritoneal mesotheliomas affecting young women. A case report with differential diagnosis and review of the literature

Bercero¹,

Gracia²,

Bragado³

et al. 1997

Histopathology

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Aims: Very few cases of diffuse, malignant, peritoneal mesothelioma have been reported in young women. Distinction between peritoneal mesothelioma and serous epithelial tumours, including papillary serous carcinomas and borderline serous tumours, can be difficult. Differential diagnosis based on clinical appearance and imaging techniques is broad and inconclusive, thus the diagnosis must be confirmed by histological examination. Because the vast majority of tumours involving the peritoneal and serosal surfaces are due to primary or metastatic serous epithelial tumours, there is a tendency on the part of pathologists to disregard the possibility of mesothelioma when examining a biopsy or excision specimen. This is especially likely to occur when mesothelioma is associated with highly elevated serum levels of CA‐125, which is the typical tumoral marker of epithelial serous tumours from the ovary. The association between peritoneal mesothelioma and high serum levels of CA‐125 has been reported in the literature only in two cases. Case details: In order to avoid a misdiagnosis of this neoplasm we describe a new case of peritoneal mesothelioma in an 18‐year‐old woman with high serum levels of CA‐125. Conclusions: Besides its clinicopathological characteristics and its histological, immunohistochemical and ultrastructural features, we describe its biological behaviour, which seems to be worst when CA‐125 levels are high.

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Ultrastructural diagnosis of epithelial malignant mesothelioma

Cited by 48 publications

References 7 publications

Soft Tissue Metastasis as Initial Manifestation of Pleural Malignant Mesothelioma

Soft Tissue Metastasis as Initial Manifestation of Pleural Malignant Mesothelioma

Pathology of malignant mesothelioma

Prognostic value of high serum levels of CA‐125 in malignant secretory peritoneal mesotheliomas affecting young women. A case report with differential diagnosis and review of the literature

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