Article

Mesotheliomas with small cell features: report of eight cases.

Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Modern Pathology (Impact Factor: 6.36). 01/2012; 25(5):689-98. DOI: 10.1038/modpathol.2011.202
Source: PubMed

ABSTRACT Mesotheliomas with small cell morphology are rare and only one study of such cases has been published. As a result of their rare occurrence, some investigators have cast doubt on the existence of such a histologic variant of mesothelioma. This investigator reports a series of eight cases of epithelioid mesothelioma with small cell features, all of which originated in the pleura. Seven of the patients were men and one was a woman. Four patients had a history of asbestos exposure. Histologically, four of the mesotheliomas were epithelioid and four biphasic. The proportion of small cells seen in these cases constituted 80 to 100% of the tumor included in the biopsy material and 15 to 20% of the tumor present in the pneumonectomy specimens. Immunoreactivity for calretinin, keratin 5/6, keratin 7, pan-keratin, WT1, podoplanin, and mesothelin was seen in all cases tested for these markers. All of the cases were negative for MOC-31, Ber-EP4, CEA, CD15, TAG-72, TTF-1, chromogranin A, synaptophysin, CD99, and desmin. The mean survival of the six patients for whom this information was available was 8.2 months. It is important for pathologists to be aware that mesotheliomas can present small cell features and, because of this, they can be confused with other malignancies that can exhibit similar morphology. The value of immunohistochemistry in the differential diagnosis of these tumors is discussed.

0 Bookmarks
 · 
64 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The increased use of asbestos in Germany in the mid 1970s led occupational physicians, pulmonologists, thoracic surgeons and pathologists to the expectation of an increasing incidence and mortality in patients with pleural mesothelioma up to 2020. Prerequisite for curative surgery is a pathological anatomical tumor diagnosis on the basis of a biopsy and accurate tumor staging. In order to achieve reproducible results in the assessment of malignant pleural diseases, the pathological anatomical diagnosis of malignant pleural mesothelioma should be made according to the guidelines of the international mesothelioma interest group (IMIG). Currently used multimodal thoracic surgery therapeutic concepts present new challenges and problems to the pathological anatomical diagnosis and are discussed in this article.
    Der Chirurg 06/2013; 84(6):479-86. · 0.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Der Anstieg des Asbestverbrauchs in Deutschland in der Mitte der 1970er Jahre führt dazu, dass Arbeitsmediziner, Pneumologen, Thoraxchirurgen und Pathologen bis 2020 mit einer steigenden Inzidenz und Mortalität von Patienten mit Pleuramesotheliomen zu rechnen haben. Voraussetzung für die kurative operative Therapie ist die pathologisch-anatomische Tumorsicherung anhand der Biopsie und eine möglichst korrekte Stadieneinteilung. Um zu reproduzierbaren Ergebnissen in der Beurteilung maligner Pleuraerkrankungen zu kommen, sollte die pathologisch-anatomische Diagnostik maligner Pleuramesotheliome entsprechend den Richtlinien der „International Mesothelioma Interest Group“ (IMIG) erfolgen. Gegenwärtig verwandte multimodale thoraxchirurgische Therapiekonzepte stellen die pathologisch-anatomische Diagnostik vor neue Aufgaben und Probleme, die im Folgenden vorgestellt werden.
    Der Chirurg 06/2013; 84(6). · 0.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Calretinin is a member of the EF-hand family of calcium-binding proteins. Because its expression is highly restricted to mesotheliomas, calretinin is, at present, the most commonly used positive mesothelioma marker that is most often recommended to be included in the various immunohistochemical panels used to assist in the differential diagnosis of these tumors. Calretinin expression has also been reported to be commonly expressed in a wide variety of other neoplasms, including sex cord-stromal tumors, adrenal cortical neoplasms, olfactory neuroblastomas, Schwann cell tumors, cardiac myxomas, and ameloblastomas. This article reviews the information that is currently available on calretinin expression in tumors and on its application as an immunohistochemical marker in diagnostic pathology.
    Applied immunohistochemistry & molecular morphology: AIMM / official publication of the Society for Applied Immunohistochemistry 10/2013; · 1.63 Impact Factor