Fluorescence In Situ Hybridization in the Definitive Diagnosis of Malignant Mesothelioma in Effusion Cytology

Guidelines for Pathologic Diagnosis of Malignant Mesothelioma: 2012 Update of the Consensus Statement from the International Mesothelioma Interest Group

“…The FISH technique for detection of 9p21 deletions has been shown to be a very powerful technique for confirming the diagnosis of malignant mesothelioma in effusion and formalin-fixed, paraffin-embedded tissue specimens ( Figure 19, A and B). 19,20,86,88,89 The diagnosis of atypical mesothelial proliferation is more common in cytologic specimens than in surgical specimens because the diagnosis of mesothelioma can be more challenging in cytologic specimens because of the inability to evaluate for tissue invasion and of the numerous cytomorphologic mimics of mesothelioma, including reactive mesothelial proliferations. In the diagnosis of MM in effusion cytology across all cytologic categories, studies showed an overall sensitivity of p16 FISH between 56% and 79% with a positive predictive value of 100%.…”

Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations

“…A combination of CCL2, galectin-3, and soluble mesothelin-related peptides (SMRP) may discriminate between malignant mesothelioma patients and patients with metastatic adenocarcinoma or nonmalignant pleural effusion (21). Similarly, fluorescent in-situ hybridization (FISH) for homozygous deletion of p16 (INK2A) is a promising technique for distinguishing benign and malignant mesothelial pleural proliferations (22,23).…”

Pre-analytical issues in effusion cytology

“…Changes in the same chromosomes were assessed in another study, in which smears fixed in Delaunay solution, containing ethanol and acetone, and PAP-stained smears were used [51]. FISH, chromogenic ISH (CISH) or silver ISH (SISH) are also applied to assessment of HER2 status.…”