[Immunohistochemistry of mesotheliomas. Technique and current diagnostic contribution of immunohistochemical markers. General review].
Diagnosis of mesothelioma is a difficult clinical and pathological task. The morphology of the neoplasm is extremely variable and is the major cause of the diagnostic dilemma. Malignant mesotheliomas are difficult to distinguish from benign reactive lesions of the pleura and from metastatic neoplasms, particularly adenocarcinomas and IVBAT (intravascular bronchioloalveolar tumor better referred to as sclerosing angiosarcoma or epithelioid hemangioendothelioma). Immunohistochemical studies represent a crucial diagnosis aid. A practical approach in different morphological situations is described and a routine antibody panel is proposed: the dual negativity of CEA and Leu M1 associated with thick "hairy" brush borders with EMA staining suggest malignant epithelial mesothelioma. The dual positivity of CEA and Leu M1 and the presence of thin smooth borders staining with EMA suggest adenocarcinomas. Behind a spindle-cell neoplasm the coexpression of keratin, vimentin and the presence of keratin-positive cells infiltrating underlying tissue suggest malignant desmoplastic mesothelioma.
Galateau-Salle
F
F
Service d'Anatomie Pathologique, CHU, Côte de Nacre, Caen.
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000943:Antigens, Differentiation; D014408:Biomarkers, Tumor; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000473:pathology
D000943:Antigens, Differentiation; D014408:Biomarkers, Tumor
Immunohistochimie des mésothéliomes. Technique et apport diagnostique actuel des marqueurs immunohistochimiques. Revue générale.