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Lung Cancer. 2018 Oct;124:95-101. doi: 10.1016/j.lungcan.2018.07.041. Epub 2018 Jul 30.

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.

Author information

1
Department of Pathology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada. Electronic address: achurg@mail.ubc.ca.
2
Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan.
3
Unit of Pathological Anatomy, University Hospital of Pisa, Italy.
4
Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Italy.
5
Genetic Cancer Susceptibility Group, Section of Genetics, International Agency for Research on Cancer, Lyon, France.
6
Centre National Référent MESOPATHm Centre Leon Berard, Lyon, France.

Abstract

OBJECTIVES:

The separation of benign from malignant mesothelial proliferations and exact subclassification of mesothelioma subtypes is crucial to determining patient care and prognosis but morphologically can be very difficult.

METHODS:

This session of the 2018 IMIG meeting addressed these problems.

RESULTS:

A new immunohistochemical marker, methylthioadenosine phosphorylase, was shown to correlate well with CDKN2A FISH and is cheaper and faster to run. A 117 gene expression panel also provided good separation on both tissue biopsy and cytology samples. Review of a series of mesotheliomas thought to be biphasic produced only a moderate level of agreement among expert pathologists with some cases being classified as purely epithelioid or sarcomatoid; these classifications had prognostic significance. The entity called transitional mesothelioma was found to behave exactly like sarcomatoid mesothelioma. RNA-seq analysis of a large series of mesotheliomas from a public database showed that, genetically, the morphologic breakdown into epithelioid, sarcomatoid, or biphasic mesotheliomas is artificial because there is a continuous spectrum of genomic changes. There are now criteria for the diagnosis of mesothelioma in situ and this is potentially important, since such cases might be curable.

CONCLUSIONS:

This session documented new morphological and molecular approaches to separating benign from malignant mesothelial proliferations and to subclassifying malignant mesoteheliomas in clinical relevant ways.

KEYWORDS:

BAP1; CDKN2A FISH; Malignant mesothelioma; Methylthioadenosine phosphorylase; Reactive mesothelial proliferations

PMID:
30268487
DOI:
10.1016/j.lungcan.2018.07.041
[Indexed for MEDLINE]

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