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Logo of jclinpathJournal of Clinical PathologyCurrent TOCInstructions for authors
J Clin Pathol. Oct 2001; 54(10): 766–770.
PMCID: PMC1731284

Malignant mesothelioma: a comparison of biopsy and postmortem material by light microscopy and immunohistochemistry

Abstract

Aims—The diagnosis of malignant mesothelioma in pleural biopsies can be difficult. Survival is short and consequently many of these cases are submitted to necropsy to assist with medicolegal claims. This study compares the histological appearances and immunohistochemical profile of nine biopsy specimens with corresponding postmortem specimens.

Methods—Archival, formalin fixed, paraffin wax embedded material was obtained from nine biopsy and corresponding postmortem cases of malignant mesothelioma. The specimens were examined by light microscopy and stained with an immunohistochemical panel of 12 commercially available antibodies including CAM5.2, HBME-1, and Ber-EP4, and antibodies to thrombomodulin, calretinin, CD44H, WT-1, carcinoembryonic antigen, Leu-M1, epithelial membrane antigen and p53.

Results—There was greater variation in the range of histological appearances of mesotheliomas in postmortem specimens compared with biopsy specimens. There was also variability in the immunohistochemical staining pattern for certain antibodies including HBME-1, and Ber-EP4 and antibodies to calretinin, CD44H, WT-1, and p53.

Conclusions—All available information should be taken into account in the histological diagnosis of malignant mesothelioma. Interpretation of the immunohistochemical profile should be regarded with some caution when only postmortem material is available. When reporting a postmortem case of suspected mesothelioma, the pathologist should seek to review all available biopsy material in conjunction with the necropsy.

Key Words: malignant mesothelioma • biopsy • necropsy • immunohistochemistry

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Selected References

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  • Dorward AJ, Stack BH. Diffuse malignant pleural mesothelioma in Glasgow. Br J Dis Chest. 1981 Oct;75(4):397–402. [PubMed]
  • Wirth PR, Legier J, Wright GL., Jr Immunohistochemical evaluation of seven monoclonal antibodies for differentiation of pleural mesothelioma from lung adenocarcinoma. Cancer. 1991 Feb 1;67(3):655–662. [PubMed]
  • Ordóez NG. The value of antibodies 44-3A6, SM3, HBME-1, and thrombomodulin in differentiating epithelial pleural mesothelioma from lung adenocarcinoma: a comparative study with other commonly used antibodies. Am J Surg Pathol. 1997 Dec;21(12):1399–1408. [PubMed]
  • Riera JR, Astengo-Osuna C, Longmate JA, Battifora H. The immunohistochemical diagnostic panel for epithelial mesothelioma: a reevaluation after heat-induced epitope retrieval. Am J Surg Pathol. 1997 Dec;21(12):1409–1419. [PubMed]
  • Garcia-Prats MD, Ballestin C, Sotelo T, Lopez-Encuentra A, Mayordomo JI. A comparative evaluation of immunohistochemical markers for the differential diagnosis of malignant pleural tumours. Histopathology. 1998 May;32(5):462–472. [PubMed]
  • Cury PM, Butcher DN, Fisher C, Corrin B, Nicholson AG. Value of the mesothelium-associated antibodies thrombomodulin, cytokeratin 5/6, calretinin, and CD44H in distinguishing epithelioid pleural mesothelioma from adenocarcinoma metastatic to the pleura. Mod Pathol. 2000 Feb;13(2):107–112. [PubMed]
  • Oates J, Edwards C. HBME-1, MOC-31, WT1 and calretinin: an assessment of recently described markers for mesothelioma and adenocarcinoma. Histopathology. 2000 Apr;36(4):341–347. [PubMed]
  • Attanoos RL, Gibbs AR. Pathology of malignant mesothelioma. Histopathology. 1997 May;30(5):403–418. [PubMed]
  • Skov BG, Lauritzen AF, Hirsch F, Nielsen HW. The histopathological diagnosis of malignant mesothelioma v. pulmonary adenocarcinoma: reproducibility of the histopathological diagnosis. Histopathology. 1994 Jun;24(6):553–557. [PubMed]
  • Attanoos RL, Dojcinov SD, Webb R, Gibbs AR. Anti-mesothelial markers in sarcomatoid mesothelioma and other spindle cell neoplasms. Histopathology. 2000 Sep;37(3):224–231. [PubMed]
  • 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 Aug;110(2):191–199. [PubMed]
  • Brown RW, Clark GM, Tandon AK, Allred DC. Multiple-marker immunohistochemical phenotypes distinguishing malignant pleural mesothelioma from pulmonary adenocarcinoma. Hum Pathol. 1993 Apr;24(4):347–354. [PubMed]
  • Betta PG, Andrion A, Donna A, Mollo F, Scelsi M, Zai G, Terracini B, Magnani C. Malignant mesothelioma of the pleura. The reproducibility of the immunohistological diagnosis. Pathol Res Pract. 1997;193(11-12):759–765. [PubMed]
  • Ordóez NG. The immunohistochemical diagnosis of epithelial mesothelioma. Hum Pathol. 1999 Mar;30(3):313–323. [PubMed]
  • Fisher CJ, Gillett CE, Vojtesek B, Barnes DM, Millis RR. Problems with p53 immunohistochemical staining: the effect of fixation and variation in the methods of evaluation. Br J Cancer. 1994 Jan;69(1):26–31. [PMC free article] [PubMed]
  • Bassarova AV, Popov AA. Immunohistochemical detection of p53--effect of fixation and methods of antigen retrieval. Folia Histochem Cytobiol. 1998;36(3):127–132. [PubMed]

Figures and Tables

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Figure 1 (A) Biopsy of sarcomatoid mesothelioma (case 8). This case shows a typical spindle cell pattern (haematoxylin and eosin; original magnification, x400). (B) Postmortem appearances of the same case. The tumour is composed of bizarre, pleomorphic ...

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