Cellular Classification
Histologically, these tumors are composed of fibrous or epithelial elements or
both. The epithelial form occasionally causes confusion with peripheral
anaplastic lung carcinomas or metastatic carcinomas. Attempts at diagnosis by
cytology or needle biopsy of the pleura are often unsuccessful. It can be
especially difficult to differentiate mesothelioma from adenocarcinoma on small
tissue specimens. Thoracoscopy can be valuable in obtaining adequate tissue
specimens for diagnostic purposes.[1] Examination of the gross tumor at
surgery and use of special stains or electron microscopy can often help. The
special stains reported to be most useful include periodic acid-Schiff
diastase, hyaluronic acid, mucicarmine, CEA, and Leu M1.[2] Histologic
appearance seems to be of prognostic value, and most clinical studies
show that patients with epithelial mesotheliomas have a better prognosis than those with sarcomatous
or mixed histology mesotheliomas.[2-4]
References
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Boutin C, Rey F: Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 1: Diagnosis. Cancer 72 (2): 389-93, 1993.
[PUBMED Abstract]
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Chahinian AP, Pass HI: Malignant mesothelioma. In: Holland JC, Frei E, eds.: Cancer Medicine e.5. 5th ed. Hamilton, Ontario: B.C. Decker Inc, 2000, pp 1293-1312.
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Nauta RJ, Osteen RT, Antman KH, et al.: Clinical staging and the tendency of malignant pleural mesotheliomas to remain localized. Ann Thorac Surg 34 (1): 66-70, 1982.
[PUBMED Abstract]
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Sugarbaker DJ, Strauss GM, Lynch TJ, et al.: Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. J Clin Oncol 11 (6): 1172-8, 1993.
[PUBMED Abstract]
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