Synchronous diffuse malignant mesothelioma and carcinomas in asbestos‐exposed individuals

Attanoos, Richard; Thomas, D H; Gibbs, A R

doi:10.1046/j.1365-2559.2003.01685.x

Cited by 43 publications

(41 citation statements)

References 16 publications

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“…[19][20][21] In addition, cases of a collision tumor formed by a mesothelioma and a small cell lung carcinoma, although exceedingly rare, have also been documented. 22 Microscopically, the cytoplasmic features of small cell mesothelioma differ subtly from those of small cell lung carcinoma in that, although both types of tumors exhibit a high nuclear cytoplasmic ratio, the amount of cytoplasm in the mesotheliomas with small cell features is greater. In small cell lung carcinomas, cell borders are rarely seen and the nuclei often present a 'saltand-pepper' chromatin and nuclear molding, and lack nucleoli, while in small cell mesotheliomas, the nuclei are more vesicular with finely granular and dispersed chromatin, they more often contain small, but well-defined, nucleoli, and exhibit no nuclear molding.…”

Section: Discussionmentioning

confidence: 99%

Mesotheliomas with small cell features: report of eight cases

Ordóñez

2012

Modern Pathology

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Mesotheliomas with small cell morphology are rare and only one study of such cases has been published. As a result of their rare occurrence, some investigators have cast doubt on the existence of such a histologic variant of mesothelioma. This investigator reports a series of eight cases of epithelioid mesothelioma with small cell features, all of which originated in the pleura. Seven of the patients were men and one was a woman. Four patients had a history of asbestos exposure. Histologically, four of the mesotheliomas were epithelioid and four biphasic. The proportion of small cells seen in these cases constituted 80 to 100% of the tumor included in the biopsy material and 15 to 20% of the tumor present in the pneumonectomy specimens. Immunoreactivity for calretinin, keratin 5/6, keratin 7, pan-keratin, WT1, podoplanin, and mesothelin was seen in all cases tested for these markers. All of the cases were negative for MOC-31, Ber-EP4, CEA, CD15, TAG-72, TTF-1, chromogranin A, synaptophysin, CD99, and desmin. The mean survival of the six patients for whom this information was available was 8.2 months. It is important for pathologists to be aware that mesotheliomas can present small cell features and, because of this, they can be confused with other malignancies that can exhibit similar morphology. The value of immunohistochemistry in the differential diagnosis of these tumors is discussed.

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Section: Discussionmentioning

confidence: 99%

Mesotheliomas with small cell features: report of eight cases

Ordóñez

2012

Modern Pathology

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“…In particular, numerous studies have investigated the co-existence of mesothelioma with other primary malignancies [77][78][79][80] . The association between mesothelioma and other cancers, such as nonHodgkin lymphoma or hepatocellular carcinoma, could indicate a role of immune impairment in the genesis of mesothelioma 78,80) .…”

Section: Co-factorsmentioning

confidence: 99%

Malignant Mesothelioma: Global Incidence and Relationship with Asbestos

2007

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Mesothelioma incidence varies markedly from one country to another. The highest annual crude incidence rates (about 30 cases per million) are observed in Australia, Belgium, and Great Britain. A lot of data indicate a relationship between mesothelioma and asbestos. The hot areas for mesothelioma exactly correspond to the sites of industries with high asbestos use, such as shipbuilding and asbestos-cement industry. However, in many countries with high asbestos consumption, mesothelioma incidence is low. The reasons for this fact are not clear. The latency periods elapsing between first exposure to asbestos and development of mesothelioma are mostly longer than 40 yr. An inverse relationship exists between intensity of asbestos exposure and length of the latency period. Mesothelioma generally develops after long-time exposures to asbestos. Some recent studies show that the risk increases with the duration of exposure. Possible co-factors in the pathogenesis of asbestos-related mesothelioma include genetic predisposition, diets poor in fruit and vegetables, viruses, immune impairment, recurrent serosal inflammation. The study of co-morbidity in mesothelioma could give an insight into the pathogenesis of the tumor. While a levelling-off in mesothelioma incidence has been registered in some countries, a worsening of the epidemic is predictable in large parts of the world.

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“…1 Furthermore, cases of concomitant mesothelioma and squamous carcinoma have been documented. 4,5 In one instance, a mesothelioma was intimately admixed with a squamous carcinoma of the lung forming a collision tumor. 4 Over the past two decades, numerous studies have been published on the value of immunohistochemistry as an ancillary technique in the diagnosis of mesotheliomas and there is general agreement that this method is extremely useful in the diagnosis of these tumors.…”

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confidence: 99%

“…4,5 In one instance, a mesothelioma was intimately admixed with a squamous carcinoma of the lung forming a collision tumor. 4 Over the past two decades, numerous studies have been published on the value of immunohistochemistry as an ancillary technique in the diagnosis of mesotheliomas and there is general agreement that this method is extremely useful in the diagnosis of these tumors. The primary focus of the large majority of these investigations, however, has been on the distinction between epithelioid mesotheliomas and adenocarcinomas, especially those originating in the lung, but very little has been published comparing the immunoprofiles of epithelioid mesotheliomas and squamous carcinomas.…”

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confidence: 99%

The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung: a comparative study

2006

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As both mesotheliomas and squamous carcinomas can present a wide variety of morphological patterns, they can on occasion be confused. Recently, some groups of investigators have called attention to the difficulties that sometimes exist in distinguishing between these malignancies and the need to define a panel of markers that can assist in reaching the correct diagnosis. The aim of the present study is to compare the value of the various immunohistochemical markers currently available for the diagnosis of mesothelioma and squamous carcinoma of the lung. A total of 30 epithelioid pleural mesotheliomas exhibiting a solid or predominantly solid pattern, and 30 nonkeratinizing squamous carcinomas of the lung were investigated for the expression of the following markers: podoplanin, calretinin, mesothelin, WT1, keratin 5/6, keratin 7, p63, carcinoembryonic antigen (CEA), MOC-31, Ber-EP4, B72.3, BG-8 (Lewis y ), leu-M1 (CD15), and thyroid transcription factor-1 (TTF-1). All 30 (100%) of the mesotheliomas reacted for calretinin, mesothelin and keratin 7, 93% each for podoplanin, WT1 and keratin 5/6, 13% for Ber-EP4, 7% each for p63, MOC-31 and BG-8, and 0% for B72.3, CEA, leu-M1 and TTF-1. All 30 (100%) of the squamous carcinomas were positive for p63 and keratin 5/6, 97% for MOC-31, 87% for Ber-EP4, 80% for BG-8, 77% for CEA, 57% for keratin 7, 40% for calretinin and B72.3, 30% for leu-M1, 27% for mesothelin, 15% for podoplanin, and 0% for WT 1 and TTF-1. After analyzing the results, it is concluded that from a practical point-of-view, a combination of two positive mesothelioma markers (WT1 and calretinin or mesothelin) with two negative mesothelioma markers (p63 and MOC-31) would allow the differential diagnosis to be established between epithelioid mesotheliomas and squamous carcinomas of the lung in nearly all instances.

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Synchronous diffuse malignant mesothelioma and carcinomas in asbestos‐exposed individuals

Cited by 43 publications

References 16 publications

Mesotheliomas with small cell features: report of eight cases

Mesotheliomas with small cell features: report of eight cases

Malignant Mesothelioma: Global Incidence and Relationship with Asbestos

The diagnostic utility of immunohistochemistry in distinguishing between epithelioid mesotheliomas and squamous carcinomas of the lung: a comparative study

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