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Reviews mrhfm for mesothelioma. 76 78 its banal appearance belies the aggressive nature of this tumour. The immunostains selected for further workup of a mm are dictated by the histologic category into which it falls916. By locating distinct protein antigen markers within mesothelioma tumor cells a diagnosis can be made that is far more accurate than diagnoses using imaging.
Large surgical biopsies are generally needed. Sarcomatoid mesothelioma is now more of a challenge than epithelioid or biphasic mesothlioma. Desmoplastic malignant mesothelioma dmm is an under recognised variant of malignant mesothelioma that can be deceptively bland.
The identification of features of malignancy in a desmoplastic mesothelioma requires adequate tissue and the amount of tissue in a closed pleural biopsy is often insufficient. Pleura peritoneum diffuse malignant mesothelioma. Immunohistochemistry ihc has become an invaluable tool in the differentiation of histological mesothelioma subtypes with the use of antigens which are substances that trigger the production of antibodies by the immune system.
This subtype which accounts for 510 of malignant mesotheliomas most commonly affects the pleura. When a substantial amount of solid malignant tumor with histologic features of mm ie a tumor mass is identied. Highlighted with immunostains such as pancytokeratin or calretinin.
Up to 30 casesmillion peopleyear in australia great britain. Markers that have a high sensitivity for epithlioid mesotherlioma tend to have far lower sensitivity in sarcomatoid mesothelioma. Am j clin pathol 1998.
Invasion by mesothelioma is often subtle and may be into only a few layers of collagenous tissue below the mesothelial space and lacking a desmoplastic reaction. The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy.
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