Seneste videoer

Hjem
Artikler

Mesothelioma Pathology - Making the Diagnosis of Mesothelioma administrator 0 Visninger • 2 flere år siden

Mesothelioma Pathology
➡️ http://MesotheliomaUSA.net

Usefulness of immunohistochemistry in an accurate diagnosis.

The histochemical staining of hyarulonic acid and electron microscopic studies have been widely used in the past for making a differential diagnosis between mesothelioma and other tumors. However, immunohistochemical stains are currently the method of choice because of the simplicity and ease of these techniques. Many antibodies have been detected for use in immunohistochemical staining techniques aimed at diagnosing mesothelioma, but as yet there is no antibody that is completely specific for mesothelioma and on which a pathological diagnosis of mesothelioma can be singly based. Therefore, the combination of a number of antibodies as positive or negative markers is important, and an assessment of the results in a comprehensive manner is necessary.

In the case of epithelioid mesothelioma, calretinin, WT1, thrombomodulin, mesothelin and D2-40 can be applied as a mesothelial cell marker. CEA, TTF-1, Napsin A and surfactant apoprotein are used as markers for lung adenocarcinoma. In the case of ovarian serous papillary adenocarcinoma, we recommend CEA, Ber-EP4, MOC-31 and ER (estrogen receptor) as positive markers.

The antibodies chosen for sarcomatoid mesothelioma are very different from those used for epithelioid mesothelioma. In the case of sarcomatoid mesothelioma, cytokeratin (AE1/AE3 or CAM5.2 as antibodies) exhibits a high specificity and is the most useful. On the other hand, because the diagnosis for true sarcoma is based on the specific differentiation of tumor cells, mesothelioma is eliminated by making its differentiation clear. For example, the following antibodies are known to be useful: MyoD1, desmin and myoglobin for rhabdomyosarcoma; desmin, α-SMA and h-caldesmon for leiomyosarcoma; S-100p for malignant nerve sheath tumor; KP-1 for malignant fibrous histiocytoma.

The most difficult tumor to be differentiated from sarcomatoid mesothelioma of pleura is sarcomatoid carcinoma (spindle cell carcinoma, pleomorphic carcinoma) of the lung. When immunohistochemical stainings are used, both respond positively to cytokeratin. In this case, therefore, the gross finding or the clinical diagnosis by imaging is very important, as already mentioned.

Immunohistochemical stains may be useful in differentiating between fibrous pleuritis and desmoplastic mesothelioma. Desmin is positive for spindle cells of the fibrous pleuritis, while desmin is negative for tumor cells of the sarcomatoid mesothelioma. The combination of EMA, desmin and p53 is useful for differentiating between reactive mesothelial hyperplasia and early-stage epithelioid mesothelioma. Reactive mesothelial cells are positive for desmin and negative for EMA and p53.

Compensation or relief of patients.

In the compensation system for occupational exposures to asbestos and in the new law for non-occupational exposure to asbestos, if the diagnosis of mesothelioma is certain, it can almost always be presumed to be related to asbestos exposure and the patients can receive compensation or relief. Therefore, the accuracy of the pathological diagnosis as mesothelioma is very important. However, a rough estimate is that approximately 10–15% of mesothelioma patients receive an inadequate diagnosis. In the committee for the judgement of patients’ relief, 30% of applicants are judged as not having mesothelioma or the decision is deferred until additional evidence is provided. It is therefore essential that Japanese clinicians and pathologists make an effort to improve the accuracy of the diagnosis as mesothelioma. In particular, the pathologists must improve the accuracy of the pathological diagnosis using adequate immunohistochemical stains.

Mesothelioma Pathology - Making the Diagnosis of Mesothelioma
https://www.youtube.com/watch?v=juB7NytMsaE
https://www.youtube.com/channe....l/UCOVJwa1zpdmoeq2db

#mesotheliomapathology #mesotheliomapathologypapillary #mesotheliomapathologyppt

🔗 https://www.ncbi.nlm.nih.gov/p....mc/articles/PMC26982

Sarcomatoid Mesothelioma - Diagnosing Sarcomatoid Mesothelioma administrator 0 Visninger • 2 flere år siden

Sarcomatoid Mesothelioma
➡️ http://MesotheliomaUSA.net

Diagnosing Sarcomatoid Mesothelioma.

Properly identifying mesothelioma cell type is an important aspect of the diagnostic process. Sarcomatoid malignant mesothelioma is difficult to accurately diagnose because of its rarity and resemblance to other conditions.

Diagnosis typically begins with imaging tests, including an X-ray and CT scan. These tests will identify any visible tumors or excess fluid in the chest cavity. If cancer is suspected, doctors may order a blood test. This test identifies biomarkers that can differentiate mesothelioma from other conditions.

A biopsy is the most important step in making an accurate sarcomatoid mesothelioma diagnosis. Cell type can be determined through a tissue biopsy and analyses of the sample, such as immunohistochemistry. This is a staining method that uses specific antibodies to isolate antigens or proteins in the tissue sample.

Through an immunohistochemical stain, a pathologist can identify if a tumor is benign or malignant, as well as determine cell type, stage and prognosis.

Several immunohistochemical markers can indicate mesothelioma. Studies have found stains that test positive for proteins calretinin and D2-40, in combination with the antibody pancytokeratin, are the most accurate indicator of sarcomatoid mesothelioma.

Multiple biopsies may be necessary to determine if a patients’ tumors solely exhibit sarcomatoid cells. In some cases, epithelioid cells may also be present, indicating biphasic mesothelioma. Additional tests may also be needed to make an accurate differential diagnosis.

Common misdiagnoses of sarcomatoid mesothelioma include:

Fibrous pleurisy.
Fibrous tumors.
Fibrosarcoma.
Metastasized renal sarcoma.
Non-Hodgkin’s lymphoma.
Pleural liposarcoma.
Sarcomatoid carcinoma.
Soft tissue sarcomas.

Rare Sarcomatoid Cell Types.

In some cases, sarcomatoid mesothelioma may also be differentiated as several rare cell types. These cell types are known for rapid metastasis and poor prognosis. These subtypes may have even more limited treatment options than standard sarcomatoid tumors.

Desmoplastic mesothelioma: Desmoplastic cells often form without a defined pattern. Desmoplastic mesothelioma is most common in the pleura (lining of the lungs), but has also presented in cases of peritoneal and testicular mesothelioma. It accounts for about 5% of all diagnoses. Studies have found an average life expectancy of 3.8 months.

Lymphohistiocytoid mesothelioma: This rare form accounts for less than 1% of all diagnoses. It typically forms in the pleura. Lymphohistiocytoid mesothelioma indicates tumors are made of a variety of cells, including epithelial cells and immune cells, such as lymphocytes and plasma cells. Studies have found an average survival time of two to 20 months.

Transitional mesothelioma: Transitional cells develop similarly to other subtypes, but are characterized by a plump spindle shape. The cells sometimes closely resemble epithelial cells, making diagnosis difficult. These tumors are rare, with only a few case reports referencing the subtype.

Prognosis - Sarcomatoid Mesothelioma Prognosis.

Sarcomatoid mesothelioma has the least favorable prognosis compared to the other common cell types. Studies have shown life expectancies ranging from one month to about 28 months. The majority of patients face a median survival of six months or less.

An individual’s prognosis will also depend on the type of mesothelioma and stage at diagnosis, as well as the patient’s age, gender and overall health.

Patients with biphasic mesothelioma may face a worse prognosis if sarcomatoid cells are more dominant than epithelioid. Biphasic mesothelioma patients typically have a life expectancy of about one year. However, if sarcomatoid cells make up more than 10% of the tumor, patients may have more limited treatment options and a worse prognosis.

Treatment - Sarcomatoid Mesothelioma Treatment.

Research shows sarcomatoid mesothelioma is the most difficult to treat of all cell types. Studies suggest the cells are resistant to many standard therapies. Because malignant sarcomatoid mesothelioma spreads quickly throughout the body, surgery may not be a viable option for many patients.

Sarcomatoid Mesothelioma - Diagnosing Sarcomatoid Mesothelioma
https://www.youtube.com/watch?v=8u3wF6GUAKo
https://www.youtube.com/channe....l/UCOVJwa1zpdmoeq2db

#sarcomatoidmesotheliomaimmunotherapy #sarcomatoidmesotheliomapathology #sarcomatoidmesotheliomapathologyoutlines #sarcomatoidmesotheliomasymptoms #sarcomatoidmesotheliomatreatment #sarcomatoidmesotheliomauk #sarcomatoidmesothelioma #sarcomatoidmesotheliomahistology #sarcomatoidmesotheliomaicd10 #sarcomatoidmesotheliomaimmunohistochemistry

🔗 https://www.mesothelioma.com/m....esothelioma/types/sa

Showing 3150 out of 3151

Bemærk venligst, at hvis du er under 18 år, vil du ikke kunne få adgang til denne side.

Seneste videoer

Sprog