Advertisement

Mesothelioma pp 99-122 | Cite as

Pathological Diagnosis of Mesothelioma

  • Gabriella FontaniniEmail author
  • Greta Alì
  • Rossella Bruno
Chapter

Abstract

The diagnosis of mesothelioma is one of the most difficult challenges faced by pathologists. Its histologic diagnosis is stepwise and should be based on morphological assessment, associated with clinical and radiological findings, and supported by immunohistochemistry as well as more recent molecular tests. This neoplasm displays a wide variety of histologic patterns and the major dilemmas consist in differential diagnosis with benign mesothelial proliferations and other mimicking malignant tumors.

The histological findings of mesothelioma could facilitate its diagnosis and provide important prognostic information. The immunohistochemical approach should lie on the application of a panel including positive (mesothelial-related) and negative markers, which should be selected on the basis of morphology and clinical information. In challenging cases, molecular markers could help distinguish between benign and malignant mesothelial proliferations.

This chapter is an update of the morphological, immunohistochemical, and molecular features, with particular regard to diffuse malignant mesothelioma diagnosis.

Keywords

Diffuse malignant mesothelioma Reactive mesothelial proliferations Pathological diagnosis Immunohistochemistry Molecular markers 

References

  1. 1.
    Henderson DW, Whitaker D, Shilkin KB. The differential diagnosis of malignant messothelioma: a practical approach to diagnosis during life. In: Henderson DW, Shilkin KB, Langlois SLP, et al., editors. Malignant mesothelioma. New York: Hemisphere; 1992. p. 184.Google Scholar
  2. 2.
    Scherpereel A, Astoul P, Baas P, Berghmans T, Clayson H, de Vuyst P, et al. Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma. Eur Respir J. 2010;35:479–95.PubMedCrossRefGoogle Scholar
  3. 3.
    Sekido Y. Molecular pathogenesis of malignant mesothelioma. Carcinogenesis. 2013;34:1413–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. In: Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG, editors. WHO classification of tumours of the lung, pleura, thymus and heart, vol. 7. 4th ed. Lyon: WHO, IARC; 2015.Google Scholar
  5. 5.
    Tavassoli FA, Devilee P. In: Tavassoli FA, Devilee P, editors. Pathology and genetics: tumours of the breast and female genital organs, WHO classification of tumours series, vol. IV. Lyon: IARC Press; 2003.Google Scholar
  6. 6.
    Peterson JT, Greenberg SD, Buffler PA. Non-asbestos-related malignant mesothelioma. A review. Cancer. 1984;54:951–60.PubMedCrossRefGoogle Scholar
  7. 7.
    Carbone M, Pass HI, Rizzo P, Marinetti M, Di Muzio M, Mew DJ, et al. Simian virus 40-like DNA sequences in human pleural mesothelioma. Oncogene. 1994;9:1781–90.PubMedGoogle Scholar
  8. 8.
    Selçuk ZT, Cöplü L, Emri S, Kalyoncu AF, Sahin AA, Bariş YI. Malignant pleural mesothelioma due to environmental mineral fiber exposure in Turkey. Analysis of 135 cases. Chest. 1992;102:790–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Husain AN, Colby TV, Ordóñez NG, Allen TC, Attanoos RL, Beasley MB, et al. Guidelines for pathologic diagnosis of malignant mesothelioma: 2017 update of the consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med. 2018;142:89.PubMedCrossRefGoogle Scholar
  10. 10.
    Larsen BT, Klein JRH, Hornychová H, Nuti R, Thirumala S, Leslie KO, et al. Diffuse intrapulmonary malignant mesothelioma masquerading as interstitial lung disease: a distinctive variant of mesothelioma. Am J Surg Pathol. 2013;37:1555–64.PubMedCrossRefGoogle Scholar
  11. 11.
    Asensio JA, Goldblatt P, Thomford NR. Primary malignant peritoneal mesothelioma. A report of seven cases and a review of the literature. Arch Surg. 1990;125:1477–81.PubMedCrossRefGoogle Scholar
  12. 12.
    Churg A, Galateau-Salle F. The separation of benign and malignant mesothelial proliferations. Arch Pathol Lab Med. 2012;136:1217–26.PubMedCrossRefGoogle Scholar
  13. 13.
    Novello S, Pinto C, Torri V, Porcu L, Di Maio M, Tiseo M, et al. The third Italian consensus conference for malignant pleural mesothelioma: state of the art and recommendations. Crit Rev Oncol Hematol. 2016;104:9–20.PubMedCrossRefGoogle Scholar
  14. 14.
    Pinto C, Novello S, Torri V, Ardizzoni A, Betta PG, Bertazzi PA, et al. Second Italian consensus conference on malignant pleural mesothelioma: state of the art and recommendations. Cancer Treat Rev. 2013;39:328–39.PubMedCrossRefGoogle Scholar
  15. 15.
    van Zandwijk N, Clarke C, Henderson D, Musk AW, Fong K, Nowak A, et al. Guidelines for the diagnosis and treatment of malignant pleural mesothelioma. J Thorac Dis. 2013;5:E254–307.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. Introduction to the 2015 World Health Organization classification of tumors of the lung, pleura, thymus, and heart. J Thorac Oncol. 2015;10:1240–2.PubMedCrossRefGoogle Scholar
  17. 17.
    Arif Q, Husain AN. Malignant mesothelioma diagnosis. Arch Pathol Lab Med. 2015;139:978–80.PubMedCrossRefGoogle Scholar
  18. 18.
    Gibbs AR. Tumours of the serosal membranes. Armed forces Institute of Pathology Atlas of Tumour Pathology. Occup Environ Med. 2006;64:288.CrossRefGoogle Scholar
  19. 19.
    Kadota K, Suzuki K, Sima CS, Rusch VW, Adusumilli PS, Travis WD. Pleomorphic epithelioid diffuse malignant pleural mesothelioma: a clinicopathological review and conceptual proposal to reclassify as biphasic or sarcomatoid mesothelioma. J Thorac Oncol. 2011;6:896–904.PubMedCrossRefGoogle Scholar
  20. 20.
    Ordóñez NG. Pleomorphic mesothelioma: report of 10 cases. Mod Pathol. 2012;25:1011–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Ordóñez NG. Deciduoid mesothelioma: report of 21 cases with review of the literature. Mod Pathol. 2012;25:1481–95.PubMedCrossRefGoogle Scholar
  22. 22.
    Kadota K, Suzuki K, Colovos C, Sima CS, Rusch VW, Travis WD, et al. A nuclear grading system is a strong predictor of survival in epitheloid diffuse malignant pleural mesothelioma. Mod Pathol. 2012;25:260–71.PubMedCrossRefGoogle Scholar
  23. 23.
    Ordóñez NG. Mesotheliomas with small cell features: report of eight cases. Mod Pathol. 2012;25:689–98.PubMedCrossRefGoogle Scholar
  24. 24.
    Cigognetti M, Lonardi S, Fisogni S, Balzarini P, Pellegrini V, Tironi A, et al. BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations. Mod Pathol. 2015;28:1043–57.PubMedCrossRefGoogle Scholar
  25. 25.
    Klebe S, Brownlee NA, Mahar A, Burchette JL, Sporn TA, Vollmer RT, et al. Sarcomatoid mesothelioma: a clinical-pathologic correlation of 326 cases. Mod Pathol. 2010;23:470–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Klebe S, Mahar A, Henderson DW, Roggli VL. Malignant mesothelioma with heterologous elements: clinicopathological correlation of 27 cases and literature review. Mod Pathol. 2008;21:1084–94.PubMedCrossRefGoogle Scholar
  27. 27.
    Mangano WE, Cagle PT, Churg A, Vollmer RT, Roggli VL. The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining. Am J Clin Pathol. 1998;110:191–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Vigneswaran WT, Kircheva DY, Ananthanarayanan V, Watson S, Arif Q, Celauro AD, et al. Amount of epithelioid differentiation is a predictor of survival in malignant pleural mesothelioma. Ann Thorac Surg. 2017;103:962–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Sebbag G, Yan H, Shmookler BM, Chang D, Sugarbaker PH. Results of treatment of 33 patients with peritoneal mesothelioma. Br J Surg. 2000;87:1587–93.PubMedCrossRefGoogle Scholar
  30. 30.
    Sugarbaker PH, Welch LS, Mohamed F, Glehen O. A review of peritoneal mesothelioma at the Washington Cancer Institute. Surg Oncol Clin N Am. 2003;12:605–21, xi.PubMedCrossRefGoogle Scholar
  31. 31.
    Allen TC, Cagle PT, Churg AM, Colby TV, Gibbs AR, Hammar SP, et al. Localized malignant mesothelioma. Am J Surg Pathol. 2005;29:866–73.PubMedCrossRefGoogle Scholar
  32. 32.
    Crotty TB, Myers JL, Katzenstein AL, Tazelaar HD, Swensen SJ, Churg A. Localized malignant mesothelioma. A clinicopathologic and flow cytometric study. Am J Surg Pathol. 1994;18:357–63.PubMedCrossRefGoogle Scholar
  33. 33.
    Nakas A, Martin-Ucar AE, Edwards JG, Waller DA. Localised malignant pleural mesothelioma: a separate clinical entity requiring aggressive local surgery. Eur J Cardiothorac Surg. 2008;33:303–6.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Asioli S, Dal Piaz G, Damiani S. Localised pleural malignant mesothelioma. Report of two cases simulating pulmonary carcinoma and review of the literature. Virchows Arch. 2004;445:206–9.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Daya D, McCaughey WT. Well-differentiated papillary mesothelioma of the peritoneum. A clinicopathologic study of 22 cases. Cancer. 1990;65:292–6.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Butnor KJ, Sporn TA, Hammar SP, Roggli VL. Well-differentiated papillary mesothelioma. Am J Surg Pathol. 2001;25:1304–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Galateau-Sallé F, Vignaud JM, Burke L, Gibbs A, Brambilla E, Attanoos R, et al. Well-differentiated papillary mesothelioma of the pleura: a series of 24 cases. Am J Surg Pathol. 2004;28:534–40.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Malpica A, Sant’Ambrogio S, Deavers MT, Silva EG. Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases. Am J Surg Pathol. 2012;36:117–27.PubMedCrossRefGoogle Scholar
  39. 39.
    Weiss SW, Tavassoli FA. Multicystic mesothelioma. An analysis of pathologic findings and biologic behavior in 37 cases. Am J Surg Pathol. 1988;12:737–46.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Ross MJ, Welch WR, Scully RE. Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). Cancer. 1989;64:1336–46.PubMedCrossRefGoogle Scholar
  41. 41.
    Ball NJ, Urbanski SJ, Green FH, Kieser T. Pleural multicystic mesothelial proliferation. The so-called multicystic mesothelioma. Am J Surg Pathol. 1990;14:375–8.PubMedCrossRefGoogle Scholar
  42. 42.
    Katsube Y, Mukai K, Silverberg SG. Cystic mesothelioma of the peritoneum: a report of five cases and review of the literature. Cancer. 1982;50:1615–22.PubMedCrossRefGoogle Scholar
  43. 43.
    Rapisarda AMC, Cianci A, Caruso S, Vitale SG, Valenti G, Piombino E, et al. Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management. Arch Gynecol Obstet. 2018;297:1353–75.PubMedCrossRefGoogle Scholar
  44. 44.
    Hjerpe A, Ascoli V, Bedrossian C, Boon M, Creaney J, Davidson B, et al. Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology. Cytojournal. 2015;12:26.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Rakha EA, Patil S, Abdulla K, Abdulkader M, Chaudry Z, Soomro IN. The sensitivity of cytologic evaluation of pleural fluid in the diagnosis of malignant mesothelioma. Diagn Cytopathol. 2010;38:874–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Paintal A, Raparia K, Zakowski MF, Nayar R. The diagnosis of malignant mesothelioma in effusion cytology: a reappraisal and results of a multi-institution survey. Cancer Cytopathol. 2013;121:703–7.PubMedCrossRefGoogle Scholar
  47. 47.
    Segal A, Sterrett GF, Frost FA, Shilkin KB, Olsen NJ, William Musk A, et al. A diagnosis of malignant pleural mesothelioma can be made by effusion cytology: results of a 20 year audit. Pathology (Phila). 2013;45:44–8.Google Scholar
  48. 48.
    Henderson DW, Reid G, Kao SC, van Zandwijk N, Klebe S. Challenges and controversies in the diagnosis of mesothelioma: part 1. Cytology-only diagnosis, biopsies, immunohistochemistry, discrimination between mesothelioma and reactive mesothelial hyperplasia, and biomarkers. J Clin Pathol. 2013;66:847–53.PubMedCrossRefGoogle Scholar
  49. 49.
    Ismail-Khan R, Robinson LA, Williams CC, Garrett CR, Bepler G, Simon GR. Malignant pleural mesothelioma: a comprehensive review. Cancer Control. 2006;13:255–63.PubMedCrossRefGoogle Scholar
  50. 50.
    Galateau-Salle F, Churg A, Roggli V, Travis WD. World Health Organization Committee for tumors of the pleura. The 2015 World Health Organization classification of tumors of the pleura: advances since the 2004 classification. J Thorac Oncol. 2016;11:142–54.PubMedCrossRefGoogle Scholar
  51. 51.
    Husain AN. Mesothelial proliferations: useful marker is not the same as a diagnostic one. Am J Clin Pathol. 2014;141:152–3.PubMedCrossRefGoogle Scholar
  52. 52.
    Churg A, Sheffield BS, Galateau-Salle F. New markers for separating benign from malignant mesothelial proliferations: are we there yet? Arch Pathol Lab Med. 2016;140:318–21.PubMedCrossRefGoogle Scholar
  53. 53.
    Attanoos RL, Griffin A, Gibbs AR. The use of immunohistochemistry in distinguishing reactive from neoplastic mesothelium. A novel use for desmin and comparative evaluation with epithelial membrane antigen, p53, platelet-derived growth factor-receptor, P-glycoprotein and Bcl-2. Histopathology. 2003;43:231–8.PubMedCrossRefGoogle Scholar
  54. 54.
    Minato H, Kurose N, Fukushima M, Nojima T, Usuda K, Sagawa M, et al. Comparative immunohistochemical analysis of IMP3, GLUT1, EMA, CD146, and desmin for distinguishing malignant mesothelioma from reactive mesothelial cells. Am J Clin Pathol. 2014;141:85–93.PubMedCrossRefGoogle Scholar
  55. 55.
    Shi M, Fraire AE, Chu P, Cornejo K, Woda BA, Dresser K, et al. Oncofetal protein IMP3, a new diagnostic biomarker to distinguish malignant mesothelioma from reactive mesothelial proliferation. Am J Surg Pathol. 2011;35:878–82.PubMedCrossRefGoogle Scholar
  56. 56.
    Lee AF, Gown AM, Churg A. IMP3 and GLUT-1 immunohistochemistry for distinguishing benign from malignant mesothelial proliferations. Am J Surg Pathol. 2013;37:421–6.PubMedCrossRefGoogle Scholar
  57. 57.
    Husain AN, Mirza MK, Gibbs A, Hiroshima K, Chi Y, Boumendjel R, et al. How useful is GLUT-1 in differentiating mesothelial hyperplasia and fibrosing pleuritis from epithelioid and sarcomatoid mesotheliomas? An international collaborative study. Lung Cancer. 2014;83:324–8.PubMedCrossRefGoogle Scholar
  58. 58.
    Ikeda K, Tate G, Suzuki T, Kitamura T, Mitsuya T. Diagnostic usefulness of EMA, IMP3, and GLUT-1 for the immunocytochemical distinction of malignant cells from reactive mesothelial cells in effusion cytology using cytospin preparations. Diagn Cytopathol. 2011;39:395–401.PubMedCrossRefGoogle Scholar
  59. 59.
    Ikeda K, Tate G, Suzuki T, Kitamura T, Mitsuya T. IMP3/L523S, a novel immunocytochemical marker that distinguishes benign and malignant cells: the expression profiles of IMP3/L523S in effusion cytology. Hum Pathol. 2010;41:745–50.PubMedCrossRefGoogle Scholar
  60. 60.
    Lonardi S, Manera C, Marucci R, Santoro A, Lorenzi L, Facchetti F. Usefulness of Claudin 4 in the cytological diagnosis of serosal effusions. Diagn Cytopathol. 2011;39:313–7.PubMedCrossRefGoogle Scholar
  61. 61.
    Ladanyi M. Implications of P16/CDKN2A deletion in pleural mesotheliomas. Lung Cancer. 2005;49(Suppl 1):S95–8.PubMedCrossRefGoogle Scholar
  62. 62.
    Illei PB, Ladanyi M, Rusch VW, Zakowski MF. The use of CDKN2A deletion as a diagnostic marker for malignant mesothelioma in body cavity effusions. Cancer. 2003;99:51–6.PubMedCrossRefGoogle Scholar
  63. 63.
    Chung CT-S, Santos GDC, Hwang DM, Ludkovski O, Pintilie M, Squire JA, et al. FISH assay development for the detection of p16/CDKN2A deletion in malignant pleural mesothelioma. J Clin Pathol. 2010;63:630–4.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Nasu M, Emi M, Pastorino S, Tanji M, Powers A, Luk H, et al. High incidence of somatic BAP1 alterations in sporadic malignant mesothelioma. J Thorac Oncol. 2015;10:565–76.PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    Bott M, Brevet M, Taylor BS, Shimizu S, Ito T, Wang L, et al. The nuclear deubiquitinase BAP1 is commonly inactivated by somatic mutations and 3p21.1 losses in malignant pleural mesothelioma. Nat Genet. 2011;43:668–72.PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Yoshikawa Y, Sato A, Tsujimura T, Emi M, Morinaga T, Fukuoka K, et al. Frequent inactivation of the BAP1 gene in epithelioid-type malignant mesothelioma. Cancer Sci. 2012;103:868–74.PubMedCrossRefGoogle Scholar
  67. 67.
    Sheffield BS, Hwang HC, Lee AF, Thompson K, Rodriguez S, Tse CH, et al. BAP1 immunohistochemistry and p16 FISH to separate benign from malignant mesothelial proliferations. Am J Surg Pathol. 2015;39:977–82.PubMedCrossRefGoogle Scholar
  68. 68.
    Cibas ES, Corson JM, Pinkus GS. The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: the role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen. Hum Pathol. 1987;18:67–74.PubMedCrossRefGoogle Scholar
  69. 69.
    Hammar SP, Bockus DE, Remington FL, Rohrbach KA. Mucin-positive epithelial mesotheliomas: a histochemical, immunohistochemical, and ultrastructural comparison with mucin-producing pulmonary adenocarcinomas. Ultrastruct Pathol. 1996;20:293–325.PubMedCrossRefGoogle Scholar
  70. 70.
    Betta P-G, Magnani C, Bensi T, Trincheri NF, Orecchia S. Immunohistochemistry and molecular diagnostics of pleural malignant mesothelioma. Arch Pathol Lab Med. 2012;136:253–61.PubMedCrossRefGoogle Scholar
  71. 71.
    Ordóñez NG. Application of immunohistochemistry in the diagnosis of epithelioid mesothelioma: a review and update. Hum Pathol. 2013;44:1–19.PubMedCrossRefGoogle Scholar
  72. 72.
    Hwang HC, Pyott S, Rodriguez S, Cindric A, Carr A, Michelsen C, et al. BAP1 immunohistochemistry and p16 FISH in the diagnosis of sarcomatous and desmoplastic mesotheliomas. Am J Surg Pathol. 2016;40:714–8.PubMedCrossRefGoogle Scholar
  73. 73.
    Hida T, Hamasaki M, Matsumoto S, Sato A, Tsujimura T, Kawahara K, et al. BAP1 immunohistochemistry and p16 FISH results in combination provide higher confidence in malignant pleural mesothelioma diagnosis: ROC analysis of the two tests: BAP1 IHC and p16 FISH in mesothelioma. Pathol Int. 2016;66:563–70.PubMedCrossRefGoogle Scholar
  74. 74.
    Churg A, Nabeshima K, Ali G, Bruno R, Fernandez-Cuesta L, Galateau-Salle F. Highlights of the 14th international mesothelioma interest group meeting: pathologic separation of benign from malignant mesothelial proliferations and histologic/molecular analysis of malignant mesothelioma subtypes. Lung Cancer. 2018;124:95–101.PubMedCrossRefGoogle Scholar
  75. 75.
    Hida T, Hamasaki M, Matsumoto S, Sato A, Tsujimura T, Kawahara K, et al. Immunohistochemical detection of MTAP and BAP1 protein loss for mesothelioma diagnosis: comparison with 9p21 FISH and BAP1 immunohistochemistry. Lung Cancer. 2017;104:98–105.PubMedCrossRefGoogle Scholar
  76. 76.
    Bruno R, Alì G, Fontanini G. Molecular markers and new diagnostic methods to differentiate malignant from benign mesothelial pleural proliferations: a literature review. J Thorac Dis. 2018;10:S342–52.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Micolucci L, Akhtar MM, Olivieri F, Rippo MR, Procopio AD. Diagnostic value of microRNAs in asbestos exposure and malignant mesothelioma: systematic review and qualitative meta-analysis. Oncotarget. 2016;7(36):58606–37.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Churg A, Colby TV, Cagle P, Corson J, Gibbs AR, Gilks B, et al. The separation of benign and malignant mesothelial proliferations. Am J Surg Pathol. 2000;24:1183–200.PubMedCrossRefGoogle Scholar
  79. 79.
    Churg A, Cagle P, Colby TV, Corson JM, Gibbs AR, Hammar S, et al. The fake fat phenomenon in organizing pleuritis: a source of confusion with desmoplastic malignant mesotheliomas. Am J Surg Pathol. 2011;35:1823–9.PubMedCrossRefGoogle Scholar
  80. 80.
    Hwang HC, Sheffield BS, Rodriguez S, Thompson K, Tse CH, Gown AM, et al. Utility of BAP1 immunohistochemistry and p16 (CDKN2A) FISH in the diagnosis of malignant mesothelioma in effusion cytology specimens. Am J Surg Pathol. 2016;40:120–6.PubMedCrossRefGoogle Scholar
  81. 81.
    Bishop JA, Sharma R, Illei PB. Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma. Hum Pathol. 2010;41:20–5.PubMedCrossRefGoogle Scholar
  82. 82.
    Ordóñez NG. The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung: a comparative study. Mod Pathol. 2006;19:417–28.PubMedCrossRefGoogle Scholar
  83. 83.
    Tatsumori T, Tsuta K, Masai K, Kinno T, Taniyama T, Yoshida A, et al. p40 is the best marker for diagnosing pulmonary squamous cell carcinoma: comparison with p63, cytokeratin 5/6, desmocollin-3, and sox2. Appl Immunohistochem Mol Morphol. 2014;22:377–82.PubMedCrossRefGoogle Scholar
  84. 84.
    Bollinger DJ, Wick MR, Dehner LP, Mills SE, Swanson PE, Clarke RE. Peritoneal malignant mesothelioma versus serous papillary adenocarcinoma. A histochemical and immunohistochemical comparison. Am J Surg Pathol. 1989;13:659–70.PubMedCrossRefGoogle Scholar
  85. 85.
    Ordóñez NG. Value of immunohistochemistry in distinguishing peritoneal mesothelioma from serous carcinoma of the ovary and peritoneum: a review and update. Adv Anat Pathol. 2006;13:16–25.PubMedCrossRefGoogle Scholar
  86. 86.
    Attanoos RL, Webb R, Dojcinov SD, Gibbs AR. Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum. Histopathology. 2002;40:237–44.PubMedCrossRefGoogle Scholar
  87. 87.
    Ordóñez NG, Sahin AA. Diagnostic utility of immunohistochemistry in distinguishing between epithelioid pleural mesotheliomas and breast carcinomas: a comparative study. Hum Pathol. 2014;45:1529–40.PubMedCrossRefGoogle Scholar
  88. 88.
    Ordóñez NG. Value of PAX8, PAX2, napsin A, carbonic anhydrase IX, and claudin-4 immunostaining in distinguishing pleural epithelioid mesothelioma from metastatic renal cell carcinoma. Mod Pathol. 2013;26:1132–43.PubMedCrossRefGoogle Scholar
  89. 89.
    Lucas DR, Pass HI, Madan SK, Adsay NV, Wali A, Tabaczka P, et al. Sarcomatoid mesothelioma and its histological mimics: a comparative immunohistochemical study. Histopathology. 2003;42:270–9.PubMedCrossRefGoogle Scholar
  90. 90.
    Rdzanek M, Fresco R, Pass HI, Carbone M. Spindle cell tumors of the pleura: differential diagnosis. Semin Diagn Pathol. 2006;23:44–55.PubMedCrossRefGoogle Scholar
  91. 91.
    Beasley MB. Immunohistochemistry of pulmonary and pleural neoplasia. Arch Pathol Lab Med. 2008;132:1062–72.PubMedGoogle Scholar
  92. 92.
    Miettinen M, Limon J, Niezabitowski A, Lasota J. Calretinin and other mesothelioma markers in synovial sarcoma: analysis of antigenic similarities and differences with malignant mesothelioma. Am J Surg Pathol. 2001;25:610–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gabriella Fontanini
    • 1
    Email author
  • Greta Alì
    • 2
  • Rossella Bruno
    • 2
  1. 1.Department of Surgical, Medical, Molecular Pathology, and Critical AreaUniversity of PisaPisaItaly
  2. 2.Unit of Pathological AnatomyAzienda Ospedaliero Universitaria PisanaPisaItaly

Personalised recommendations