title: Discriminant analysis of malignant mesothelioma and reactive mesothelium using three-dimensional nuclear estimation.
abstract: OBJECTIVE
  The cytological diagnosis of coelomic fluid is essential for examining malignant mesothelioma (MM). However, reactive mesothelium (RM), caused by various factors, is morphologically similar to MM and thus often complicates the differential diagnosis. Here, nuclear luminance and steric alterations were assessed for the discriminant analysis of MM and RM.
  
  
  METHODS
  Thirteen epithelial MM and 11 RM cases were included. One hundred alterations in the numbers of nuclear pixels and focus layers and the coefficient of variation of nuclear luminance among layers were determined for each case to conduct discriminant analysis using the Mahalanobis distance.
  
  
  RESULTS
  A cutoff value of 0.072 allowed highly accurate discrimination of MM (89.5%) and RM (89.6%). Fifteen cells appeared in 6 agglomerates of indiscriminable MM cases. The 6 agglomerates were individually examined. Malignant cells were dominant in 3 agglomerates (50%), allowing the discrimination of malignant cases.
  
  
  CONCLUSIONS
  Discrimination using nuclear luminance and steric alterations is useful for morphologically indiscriminable MM cases. Three-dimensional analysis of agglomerates will be further investigated to improve the diagnostic accuracy.
authors.affiliation: Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan. kwashiya@cc.hirosaki-u.ac.jp
authors.forename: Kiyotada
authors.initials: K
authors.lastname: Washiya
authors.forename: Kenta
authors.initials: K
authors.lastname: Narumi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Noro
authors.forename: Shinji
authors.initials: S
authors.lastname: Hamakawa
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Furuta
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003581:Cytodiagnosis / Q000379:methods*; D003937:Diagnosis, Differential; D004847:Epithelial Cells / Q000473:pathology*; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods* / Q000592:standards; D008113:Liver Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008654:Mesothelioma / Q000473:pathology*; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D055815:Young Adult