title: [Diagnosis and staging of pleural mesothelioma].
abstract: Accurate diagnosis and staging are very important for the treatment of pleural mesothelioma. In particular, surgical indications based on diagnosis and staging must be determined carefully, since extrapleural pneumectomy (EPP) is a highly invasive surgical mode. Sufficient biopsy specimens to make a differential diagnosis of this disease should be obtained during video-assisted thoracoscopic surgery (VATS). Currently, the final diagnosis of mesothelioma is based not only on the results of hematoxylin and eosin staining but also of immunostaining using several differential markers. The International Mesothelioma Interest Group (IMIG) classification is widely used for the TNM staging of pleural mesothelioma. The IMIG classification is now applied to clinical staging with the aid of computed tomography and positron-emission tomography images, but the accuracy and usefulness of this classification for surgical indications and outcomes must be improved in future. Extended preoperative staging, for example, mediastinoscopy, contralateral VATS, and laparoscopy, are now selectively performed for the precise diagnosis of potentially resectable mesothelioma.
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
authors.forename: Jiro
authors.initials: J
authors.lastname: Okami
authors.forename: Jun
authors.initials: J
authors.lastname: Maeda
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Ayako
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Ryu
authors.initials: R
authors.lastname: Kanzaki
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000473:pathology; D020775:Thoracic Surgery, Video-Assisted
chemical_list: D014408:Biomarkers, Tumor