Differential diagnosis between mesothelioma and adenocarcinoma: a multimodal approach based on ultrastructure and immunocytochemistry

Journal Article · Fri May 01 04:00:00 EDT 1992 · Seminars in Diagnostic Pathology; (United States)

OSTI ID:7206330

Bedrossian, C W; Bonsib, S; Moran, C ^[1]

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1. Department of Pathology, Wayne State University School of Medicine, Detroit, MI (United States)

Most compensations for asbestos-related deaths secondary to cancer center around mesothelioma and bronchogenic carcinoma. The differential diagnosis between mesothelioma and adenocarcinoma is a common and troublesome one, necessitating the correlation between clinical history, radiographic findings, and pathologic examination of tissues and cells. We describe a multimodal approach based on the use of routine and special stains, immunocytochemistry, and electron microscopy for distinguishing between mesothelioma and adenocarcinoma. Once a malignant diagnosis is arrived at by careful pathological examination, the tumor is classified as mesothelioma if mesothelial cells are identified as the constituent cells of the neoplasm. Mesothelial cells are recognized by (1) their main ultrastructural features: slender and elongated microvilli, abundant intermediate filaments, and lacking secretory granules; and (2) their characteristic immunocytochemical reactivity: positivity for cytokeratin, EMA, and vimentin, and negativity for carcinoembryonic antigen (CEA), B72-3, Leu-M1, and other gland-cell markers. A variety of methods have been attempted in an effort to distinguish between reactive and malignant mesothelial cells. In practice, however, such distinction depends more on experience and expertise than in any fool-proof ancillary tests. A number of these tests are discussed along with the illustration of classical and unusual examples of mesothelioma and other pleural tumors.

• OSTI ID: 7206330
• Journal Information: Seminars in Diagnostic Pathology; (United States), Journal Name: Seminars in Diagnostic Pathology; (United States) Vol. 9:2; ISSN SDPAE; ISSN 0740-2570
• Country of Publication: United States
• Language: English

Related Subjects

560300* -- Chemicals Metabolism & Toxicology
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMAL TISSUES
ANIMALS
ASBESTOS
BODY
CARCINOGENESIS
DISEASES
ELECTRON MICROSCOPY
ENVIRONMENTAL EXPOSURE
EPITHELIUM
MAMMALS
MAN
MICROSCOPY
NEOPLASMS
PATHOGENESIS
PRIMATES
STAINS
TISSUES
VERTEBRATES