Spindle Cell Positive For Cytokeratin Mesothelioma, A Practical Approach To Undifferentiated Tumors A Review On Helpful Markers And Common Pitfalls Asian Archives Of Pathology

Spindle Cell Positive For Cytokeratin Mesothelioma, Sarcomatoid Malignant Mesothelioma Thoracic Pathology A Volume In The High Yield Pathology Series Expert Consult Online And Print 1st Edition

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Immunohistochemically the neoplastic cells were diffusely positive for vimentin cytokeratin and wilms tumor 1 wt 1. From these findings the deer was diagnosed with peritoneal sarcomatoid mesothelioma with metastasis to the pleural cavity. To undertake a comparative evaluation of three antimesothelial markers thrombomodulin cytokeratin 56 and calretinin with broad spectrum cytokeratin ae1ae3 in differentiating between sarcomatoid mesothelioma and a spectrum of spindle cell neoplasms.

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Sarcomatoid to an epithelioid appearance.

Mandala designs for coloring. Localized sarcomatoid mesotheliomas can only be diagnosed in the presence of spindle cell malignancies that exhibit immunoreactivity for cytokeratin and mesothelial markers and negative immunoreactivity for epithelial lesions in patients that show no multifocal or diffuse pleural spread and no evidence for extrapleural lesions. Immunohistochemically both the spindle shaped and epithelioid cells were at least focally positive for pancytokeratin vimentin calretinin a sma and desmin. The best discriminators among the antibodies considered to be negative markers for mesothelioma are cea moc 31 ber ep4 bg 8 and b723.

It is also found in certain types of lung cancers and breast cancers. Immunohistochemistry has a more limited role in the diagnosis and distinction of sarcomatoid mesothelioma from other spindle cell neoplasms. The combination of a broad spectrum cytokeratin with calretinin combines both high sensitivity 77 for ae1ae3 with high specificity 100 for calretinin for sarcomatoid mesothelioma and can be diagnostically useful.

Pathologists use cytokeratin 56 to stain cancer tissue samples. Based on these findings the tumor was diagnosed as sarcomatoid mesothelioma. Thirtyone malignant sarcomatoid mesotheliomas were studied.

Cytokeratin 5 and 56 in diagnosing mesothelioma. Differentiating sarcomatoid mesothelioma from other pleural based spindle cell tumours by light microscopy can be challenging especially in a biopsy. In addition s100 protein laminin and collagen iv are usually positive in true adipose tissue and can help in distinguishing 90 arch pathol lab medvol 142 january 2018 malignant mesothelioma diagnosishusain et al.

Regions horizontally oriented cytokeratin positive cells may be encountered around the fatlike spaces figure 6. Right scrotum and consisted of spindle shaped neoplastic cells that invaded the surrounding tissue. Cytokeratin 56 is a positive marker for malignant pleural mesothelioma found in more than three fourths of cases.

The role of immunohistochemistry in this differential diagnosis is not as well defined as it is for distinguishing epithelioid mesothelioma from adenocarcinoma. After analyzing the results it is concluded that calretinin cytokeratin 56 and wt1 are the best positive markers for differentiating epithelioid malignant mesothelioma from pulmonary adenocarcinoma.

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