Lymphohistiocytoid variant of malignant mesothelioma of the pleura: A series of 22 cases
ABSTRACT The lymphohistiocytoid variant of diffuse malignant mesothelioma is rare with very few cases described in the literature. It is characterized by mesothelial cells with a histiocytelike appearance and an associated dense lymphoid infiltrate. We studied clinicopathologic features and immunohistochemical patterns of a series of 22 cases. The histiocytelike cells had a mesothelial immunophenotype: AE1/AE3 (100%), calretinin (100%), CK5/6 (46%), and EMA (52%). The prominent lymphoid component showed a cytotoxic T-cell immunophenotype. Prognosis was similar to that of a large series of epithelioid diffuse malignant mesotheliomas. Formely, it was classified within the sarcomatoid type. We suggest that it should be reclassified as an epithelioid variant because of its similar behavioural characteristics. There was no evidence of Epstein-Barr virus-related infection.
Article: Observation n° 4Annales de Pathologie 06/2007; 27(3):212–218. DOI:10.1016/S0242-6498(07)91855-6 · 0.29 Impact Factor
Article: Problems in mesothelioma diagnosis[Show abstract] [Hide abstract]
ABSTRACT: Many centres are now seeing increasing numbers of patients with malignant mesothelioma. This presents pathologists involved in making the diagnosis with a number of problems, which can be divided into those encountered in making the distinction between mesothelioma and benign changes and those experienced in separating mesotheliomas from other types of epithelial and connective tissue tumours. Immunohistochemistry plays a major role in helping to make the diagnosis, but it should be interpreted with due regard to the clinical setting and radiological features, and with a knowledge of the wide morphological variations seen in mesothelioma. This review identifies some of these problems and addresses the uses and limitations of immunohistochemistry in different situations. It includes a discussion of some of the less common variants of mesothelioma and other pleural-based tumours that enter into the differential diagnosis.Histopathology 12/2008; 54(1):55-68. DOI:10.1111/j.1365-2559.2008.03178.x · 3.30 Impact Factor
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ABSTRACT: The multiplicity of epithelioid and mesenchymal forms of diffuse malignant mesothelioma includes patterns that may mimic another process. Identification of the multiplicity of patterns may help in the diagnosis of diffuse malignant mesothelioma. One pattern that has not been described is lymphangiomatoid. We observed six cases with ovoid or elongated or irregular anastomosing vascular-like spaces lined by flattened cells simulating lymphangioma. The luminal spaces could contain proteinaceous material simulating lymph but not erythrocytes. The cells lining the spaces were mesothelial by immunohistochemical staining. The lymphangiomatoid areas never constituted more than 40% of the area of the tumor on the slides. When seen in more solid areas of tumor, the lymphangiomatoid structures generally did not produce diagnostic difficulty. However, when seen at the edge of solid tumor or forming an irregular nodule or invading into adjacent adipose tissue, these lymphangiomatoid structures could be confusing. All six patients had been exposed to asbestos either by occupation or by spousal exposure. Three patients received chemotherapy. One patient died of diffuse malignant mesothelioma of the pleura.Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 08/2009; 455(2):143-8. DOI:10.1007/s00428-009-0806-y · 2.56 Impact Factor