Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: Ten Years of Clinical Experience in Relation to International Guidelines

Hjerpe, Anders; Abd‐Own, Sulaf; Dobra, Katalin

doi:10.5858/arpa.2018-0020-ra

Cited by 26 publications

(37 citation statements)

References 44 publications

(48 reference statements)

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“…Biphasic tumors often comprise elements of both epithelioid and sarcomatoid tumors (2). The mesothelial markers discussed as above applies to this subtype as well (23).…”

Section: Differentiating Mesothelioma From Metastatic Carcinomasmentioning

confidence: 99%

The Use of Immunohistochemistry, Fluorescence in situ Hybridization, and Emerging Epigenetic Markers in the Diagnosis of Malignant Pleural Mesothelioma (MPM): A Review

et al. 2020

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Malignant pleural mesothelioma (MPM) is an aggressive asbestos related disease that is generally considered to be difficult to diagnose, stage and treat. The diagnostic process is continuing to evolve and requires highly skilled pathology input, and generally an extensive list of biomarkers for definitive diagnosis. Diagnosis of MPM requires histological evidence of invasion by malignant mesothelial cells often confirmed by various immunohistochemical biomarkers in order to separate it from pleural metastatic carcinoma. Often when invasion of neoplastic mesothelial cells into adjacent tissue is not apparent, further immunohistochemical testing-namely BAP1 and MTAP, as well as FISH testing for loss of p16 (CDKN2A) are used to separate reactive mesothelial proliferation due to benign processes, from MPM. Various combinations of these markers, such as BAP1 and/or MTAP immunohistochemistry alongside FISH testing for loss of p16, have shown excellent sensitivity and specificity in the diagnosis of MPM. Additionally, over the recent years, research into epigenetic marker use in the diagnosis of MPM has gained momentum. Although still in their research stages, various markers in DNA methylation, long non-coding RNA, micro RNA, circular RNA, and histone modifications have all been found to support diagnosis of MPM with generally good sensitivity and specificity. Many of these studies are however, limited by small sample sizes or other study limitations and further research into the area would be beneficial. Epigenetic markers show promise for use in the future to facilitate the diagnosis of MPM.

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“…Biphasic tumors often comprise elements of both epithelioid and sarcomatoid tumors (2). The mesothelial markers discussed as above applies to this subtype as well (23).…”

Section: Differentiating Mesothelioma From Metastatic Carcinomasmentioning

confidence: 99%

The Use of Immunohistochemistry, Fluorescence in situ Hybridization, and Emerging Epigenetic Markers in the Diagnosis of Malignant Pleural Mesothelioma (MPM): A Review

et al. 2020

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“…There is scant reference to histology with only fleeting reference to core biopsy and no discussion of video assisted thoracic surgery (VATS) or other surgical techniques for diagnosis of mesothelioma (these may be considered beyond the scope of the guidelines' subject matter). What also fails to be acknowledged is that major thoracic (or abdominal) surgery for mesothelioma ought to require a definitive diagnosis by whatever means before it can be considered appropriate, even though it is suggested that early diagnosis by Cytology (especially early presentation with the first effusion) can lead to a better chemotherapy effect and longer overall survival that those with a histopathologic diagnosis …”

Section: Discussionmentioning

confidence: 99%

Guidelines for the 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. A proposal to be applauded and promoted but which requires updating

Sheaff

2020

Diagnostic Cytopathology

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The guidelines for the cytopathologic diagnosis of epithelioid and mixed‐type malignant mesothelioma produced by the International Mesothelioma Interest Group and which are endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology are reviewed and discussed. This (predominantly) evidence‐based document provides a robust and useful framework for diagnosticians and guideline producers to emphasise and promote the value, power and role of cytology in mesothelioma diagnosis and management with comments and suggestions about how the guidelines can be updated and improved in the future.

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“…Simultaneous dual/multiple immunostains by using peroxidase and alkaline phosphatase methods together (different chromogens) are found to be very useful in effusion cytology. Combined use of BerEp4/Calretinin, or desmin/EMA, or WT1/AE1‐AE3 are giving reliable results in different contexts, such as desmin/EMA for distinguishing malignant from reactive mesothelial proliferations; or WT1/AE1‐AE3 for grouping malignant effusions into discrete subsets narrowing the differential diagnosis . Dual staining can be applied both to cytological slides (cytospins, LBC) and cell block sections.…”

Section: Managementmentioning

confidence: 99%

Management of cytological material, pre‐analytical procedures and bio‐banking in effusion cytopathology

et al. 2019

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Serous effusion fluid is one of the most commonly encountered specimens in routine cytopathology practice. It provides invaluable information about the patient and the clinical status; but to get the most of it, specimen handling and processing must be carried out properly. Cytomorphology is the basis of a successful analysis which should complemented by ancillary tests when needed. A wide spectrum of ancillary techniquesranging from immunocytochemistry and flow cytometry to different assays of molecular pathologycan be applied to serous effusions. This article describes the acquisition and management of serous effusion fluids, methods for preservation and transportation, different techniques of cytopreparation, application of immunocytochemistry, flow cytometry, and fluorescence in-situ hybridization (FISH), as well as DNA extraction for polymerase chain reaction (PCR) and next generation sequencing (NGS). Principles of bio-banking of effusion samples are also discussed which is getting more important in correlation with the developments in personalized medicine. K E Y W O R D S bio-banking, effusion cytology, fluorescence in situ hybridisation, immunocytochemistry, molecular tests, preparation techniques, serous effusion 1 | INTRODUCTION Serous effusion fluid-pleural effusion, ascites and pericardial effusion-is one of the most commonly examined specimen types in cytopathology. Serous effusions occur in the context of a wide spectrum of benign and malignant diseases. In many clinical situations, effusion fluid is the first sample obtained and analysed, and, more often than not, this sample is the key to precise and timely diagnosis. Classical cytomorphology is still the basis of the application of all ancillary techniques. Immunocytochemistry can be accepted as part of the routine procedure since it has been used as a complementary method for years to increase the diagnostic accuracy of effusion cytology. All ancillary tests, including the modern techniques of molecular pathology, can be applied to serous effusions in routine workflow. It is a rapidly evolving field; however, some basics do not change, such as the selection of the right area/sample for DNA extraction or for fluorescence in situ hybridisation (FISH) analysis. This paper intends to be a practical handout for readers who deal with effusion samples. The acquisition and management of effusion samples are considered; preparation techniques for morphological examination and application of ancillary tests are discussed. The last part of the text deals with bio-banking of effusion specimens, which deserves sincere attention for the future of effusion cytology, regarding the new therapy options and research facilities. | ACQUISITIONEffusion fluid can be obtained in three ways:• by thoracentesis, paracentesis, pericardiocentesis with aspiration of fresh fluid into a syringe or vial,

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Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: Ten Years of Clinical Experience in Relation to International Guidelines

Cited by 26 publications

References 44 publications

The Use of Immunohistochemistry, Fluorescence in situ Hybridization, and Emerging Epigenetic Markers in the Diagnosis of Malignant Pleural Mesothelioma (MPM): A Review

The Use of Immunohistochemistry, Fluorescence in situ Hybridization, and Emerging Epigenetic Markers in the Diagnosis of Malignant Pleural Mesothelioma (MPM): A Review

Management of cytological material, pre‐analytical procedures and bio‐banking in effusion cytopathology

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