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Morphologische Diagnostik maligner Pleuramesotheliome

Morphological diagnostics of malignant pleural mesothelioma

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Zusammenfassung

Die WHO-Klassifikation der primären Pleuratumoren unterscheidet mesotheliale und mesenchymale Tumoren sowie lymphoproliferative Erkrankungen. Maligne Mesotheliome stellen dabei den häufigsten primären Pleuratumor dar. Histologisch werden epitheloide (ca. 40–60 %), sarkomatoide (ca. 20–30 %) und biphasische Mesotheliome (ca. 20–30 %) unterschieden. Die sichere morphologische Diagnose eines malignen Pleuramesothelioms erfordert einerseits zum Ausschluss insbesondere der pleuralen Dissemination eines pulmonalen oder extrapulmonalen epithelialen Malignoms den Nachweis einer mesothelialen Differenzierung mittels eines geeigneten Antikörperpanels, andererseits zur Abgrenzung gegenüber einer reaktiven mesothelialen Proliferation den Nachweis eines zumindest fokalen invasiven Wachstums. Der Ausschluss eines malignen Pleuramesothelioms induziert ggf. weitere differenzialdiagnostische Überlegungen, z. B. hinsichtlich der Primärtumorzuordnung bei nachgewiesener Pleurakarzinose.

Abstract

The World Health Organization (WHO) classification differentiates between pleural tumors of mesothelial and mesenchymal origin as well as lymphoproliferative disorders, with malignant mesotheliomas forming the most common pleural primary tumor. Histologically, epithelioid (40–60 %), sarcomatoid (20–40 %), and biphasic mesotheliomas (20–40 %) are distinguished. The certain morphological diagnosis of a malignant pleural mesothelioma requires the establishment of mesothelial differentiation by means of an appropriate panel of antibodies to exclude pleural dissemination of a pulmonary or extrapulmonary epithelial malignancy and also requires the establishment of at least focal invasive growth to distinguish from reactive mesothelial proliferation. The exclusion of a malignant pleural mesothelioma may induce further differential diagnostic considerations, e. g. concerning the assignment to a certain primary tumor after the establishment of carcinomatous pleuritis.

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Literatur

  1. Attanoos RL, Allen TC (2014) Advances in surgical pathology: mesothelioma. Lippincott Williams & Wilkens, Philadelphia

  2. Brockmann M (1992) Malignes diffuses Pleuramesotheliom – Heterogenität, Differentialdiagnose und Histogenese. HVBG, St. Augustin

  3. Churg A, Cagle PT, Roggli VL (2006) Tumors of the serosal membranes. ARP Press, Silver Spring

  4. Craighead J (2011) Epidemiology of mesothelioma and historical background. Recent Results Cancer Res 189:13–25

    Article  CAS  PubMed  Google Scholar 

  5. Perrot M de, Uy K, Anraku M et al (2007) Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma. J Thorac Cardiovasc Surg 133:111–116

    Article  PubMed  Google Scholar 

  6. Galateau-Sallé F (Hrsg) (2006) Pathology of malignant mesothelioma. Springer, Berlin Heidelberg New York

  7. Hodgson JT, Darnton A (2000) The quantitative risk of mesothelioma and lung cancer in relation to asbestos exposure. Ann Occup Hyg 44:565–601

    Article  CAS  PubMed  Google Scholar 

  8. Jones JSP, Lund C, Planteydt HT (1985) Colour atlas of mesothelioma. MTP-Press, Lancaster

  9. Junker K, Lindner M, Schütte W, Stahel R (2007) Diagnostik und Therapie des Pleuramesothelioms. Onkologie 30(Suppl 1):7–10

    Article  Google Scholar 

  10. Junker K, Krismann M (2008) Pathologie der primären Pleuratumoren. Zentralbl Chir 133:222–226

    Article  CAS  PubMed  Google Scholar 

  11. Krismann M, Jaworska M, Müller KM, Johnen G (2000) Severe chromosomal aberrations in pleural mesotheliomas with unusual mesodermal features – CGH evidence for a mesothelioma subgroup. J Mol Diag 2:209–216

    Article  CAS  Google Scholar 

  12. Krismann M, Thattamparambil P, Simon F, Johnen G (2006) Praktische Differenzialdiagnose präneoplastischer Veränderungen der Pleura und früher mesothelialer Neoplasien. Pathologe 27:99–105

    Article  CAS  PubMed  Google Scholar 

  13. Leigh J, Davidson P, Hendrie L, Berry D (2002) Malignant mesothelioma in Australia, 1945–2000. Am J Ind Med 41:188–201

    Article  PubMed  Google Scholar 

  14. Müller KM (2002) Principles of anatomy and pathology of the pleura. Eur Respir Mon 22:1–27

    Google Scholar 

  15. Müller KM (2005) Mesotheliome – Pathologie und Pathogenese. In: Manegold C (Hrsg) Pleuramesotheliom. Springer, Berlin Heidelberg New York, S 43–58

  16. Neumann V, Löseke S, Nowak D et al (2013) Malignes Pleuramesotheliom – Inzidenz, Ätiologie, Diagnostik, Therapie und Arbeitsmedizin. Dtsch Arztebl 110:319–326

    Google Scholar 

  17. Ordonez NG (2013) Application of immunohistochemistry in the diagnosis of epithelioid mesothelioma: a review and update. Hum Patol 44:1–19

    Article  CAS  Google Scholar 

  18. Peto R, Darby S, Deo H et al (2000) Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. BMJ 321:323–329

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Scharmach M, Neumann V, Müller KM, Fischer M (2006) Vergleich der Metastasierungsmuster maligner Mesotheliome und pulmonaler Karzinome. Pneumologie 60:277–283

    Article  CAS  PubMed  Google Scholar 

  20. Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC (Hrsg) (2004) WHO-Classification of tumours. Pathology and genetics of tumours of the lung, pleura, thymus and heart. IARC Press, Lyon

  21. Wagner JC, Sleggs CA, Wagner JC (1960) Diffuse pleural mesothelioma and asbestos exposure in the North-West Cape province. Br J Ind Med 17:260–271

    CAS  PubMed Central  PubMed  Google Scholar 

  22. White NW, Abratt RP (2005) Epidemiologie des Pleuramesothelioms. In: Manegold C (Hrsg) Pleuramesotheliom. Springer, Berlin Heidelberg New York, S 1–6

  23. Wittekind C, Meyer HJ (Hrsg) (2010) TNM-Klassifikation maligner Tumoren, 7. Aufl. Springer, Berlin Heidelberg New York

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Junker gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Zentrum für Pathologie, Klinikum Bremen-Mitte, St.-Jürgen-Str. 1, 28177, Bremen, Deutschland

    K. Junker

  2. Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Münster, Deutschland

    K.-M. Müller

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  1. K. Junker
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Correspondence to K. Junker.

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Junker, K., Müller, KM. Morphologische Diagnostik maligner Pleuramesotheliome. Pathologe 35, 586–590 (2014). https://doi.org/10.1007/s00292-014-1921-3

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  • DOI: https://doi.org/10.1007/s00292-014-1921-3

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