TY - JOUR
T1 - Guidelines for pathologic diagnosis of malignant mesothelioma
T2 - 2012 update of the consensus statement from the International Mesothelioma Interest Group
AU - Husain, Aliya N.
AU - Colby, Thomas
AU - Ordonez, Nelson
AU - Krausz, Thomas
AU - Attanoos, Richard
AU - Beasley, Mary Beth
AU - Borczuk, Alain C.
AU - Butnor, Kelly
AU - Cagle, Philip T.
AU - Chirieac, Lucian R.
AU - Churg, Andrew
AU - Dacic, Sanja
AU - Fraire, Armando
AU - Galateau-Salle, Francoise
AU - Gibbs, Allen
AU - Gown, Allen
AU - Hammar, Samuel
AU - Litzky, Leslie
AU - Marchevsky, Alberto M.
AU - Nicholson, Andrew G.
AU - Roggli, Victor
AU - Travis, William D.
AU - Wick, Mark
PY - 2013/5
Y1 - 2013/5
N2 - Context.- Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose. Objective.- To provide updated practical guidelines for the pathologic diagnosis of MM. Data Sources.- Pathologists involved in the International Mesothelioma Interest Group and others with an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. Conclusions.- There was consensus opinion regarding (1) distinction of benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiation of epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid mesothelioma, (7) use ofmolecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels used is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Immunohistochemical panels should contain both positive and negative markers. It is recommended that immunohistochemical markers have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining >10% is suggested for cytoplasmic membranous markers). These guidelines are meant to be a practical reference for the pathologist.
AB - Context.- Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose. Objective.- To provide updated practical guidelines for the pathologic diagnosis of MM. Data Sources.- Pathologists involved in the International Mesothelioma Interest Group and others with an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. Conclusions.- There was consensus opinion regarding (1) distinction of benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiation of epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid mesothelioma, (7) use ofmolecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels used is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Immunohistochemical panels should contain both positive and negative markers. It is recommended that immunohistochemical markers have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining >10% is suggested for cytoplasmic membranous markers). These guidelines are meant to be a practical reference for the pathologist.
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U2 - 10.5858/arpa.2012-0214-OA
DO - 10.5858/arpa.2012-0214-OA
M3 - Review article
C2 - 22929121
AN - SCOPUS:84877984464
SN - 0003-9985
VL - 137
SP - 647
EP - 667
JO - Archives of Pathology and Laboratory Medicine
JF - Archives of Pathology and Laboratory Medicine
IS - 5
ER -