Bone & Soft tissue Pathology
Monireh Halimi; Samad BeheshtiRouy; Davood Salehi; Seyed Ziaeddin Rasihashemi
Abstract
Background and Objective: Early diagnosis of malignant pleural mesothelioma (MPM) is the key point of its treatment. The main problem is the precise diagnosis of mesothelioma and its differentiation from metastatic lung adenocarcinoma. Mesothelioma exhibits complex immunohistochemical characteristics. ...
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Background and Objective: Early diagnosis of malignant pleural mesothelioma (MPM) is the key point of its treatment. The main problem is the precise diagnosis of mesothelioma and its differentiation from metastatic lung adenocarcinoma. Mesothelioma exhibits complex immunohistochemical characteristics. The aim of this study was to study hybrid immunohistochemistry in the differential diagnosis of primary malignant pleural effusion from metastatic pulmonary cancers. Material and Methods: Twenty tissue samples in paraffin blocks from the pathology department of Imam Reza Hospital in Tabriz whose pathology reports cited mesothelioma or metastatic lung adenocarcinomas, were included in the studies. These tissues were deemed appropriate for IHC in terms of tissue quality and quantity. They were studied and evaluated for pathological markers. Results: In patients with adenocarcinoma CK7 in 100% of patients (13 patients), TTF1 in 61.5% of patients (8 patients) and CEA in 53.8% of patients (7 patients) were positive, but HBME1 and Calretinin were negative for all patients. In patients with mesothelioma, HBME1 and Calretinin were positive in 100% of patients (7 patients) and TTF1, CEA and CK7 were negative. Conclusion: The results of this study showed that CEA, CK7, TTF1, Calretinin and HBME1 are suitable criteria for differentiating between metastatic lung adenocarcinoma and mesothelioma, and can differentiate the mesothelioma and adenocarcinoma with high accuracy.
Sandhya Venkatachala; Swarna Shivakumar; Meganathan Prabhu; Ramya Padilu
Abstract
Background & objective:Primary pleural neoplasms are rare entities compared with the pleural involvement by metastatic carcinoma. The current study aimed at investigating the complete spectrum of pleural neoplasms and differentiating between them with the aid of immunohistochemistry (IHC). Methods: ...
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Background & objective:Primary pleural neoplasms are rare entities compared with the pleural involvement by metastatic carcinoma. The current study aimed at investigating the complete spectrum of pleural neoplasms and differentiating between them with the aid of immunohistochemistry (IHC). Methods: Consecutive pleural biopsy specimens positive for a neoplasm, both primary and metastatic, were included in the study. Diagnosis or a differential diagnosis was suggested on histopathology confirmed by a panel of IHC markers such ascytokeratin (AE1/AE3), epithelial membrane antigen (EMA), vimentin, calretinin, CD34, CD99, SMA, bcl2, S100, CK7,CK20,TTF1,GCDFP, HMB45, LCA, synaptophysin, chromogranin, and naspsin. Results: A total of 35 cases of pleural neoplasms included 15 (42.9%) primary pleural neoplasms and 20 (57.1%) metastatic carcinoma. Synovial sarcoma, malignant mesothelioma (MM), and solitary fibrous tumor (SFT) accounted for 14.2%, 11.4%, and 8.5% of metastatic cases, respectively. Epithelioid sarcoma (ES), neuroendocrine carcinoma, and inflammatory myofibroblastic tumor were less common, each contributing to 2.9% of pleural neoplasms. Among the 20 cases of metastatic carcinoma, 13 were from the lung and 7 from the breast. Lung neoplasms metastasizing to the pleura were adenocarcinoma (n=12) and atypical carcinoid (n=1). Conclusion: Analysis of histopathological pattern along with a panel of appropriate IHC markers distinguished the rare entities of pleural neoplasms essential to determine the prognosis and treatment modality.