title: Diagnostic efficacy of electron microscopy and pleural effusion cytology for the distinction of pleural mesothelioma and lung adenocarcinoma.
abstract: The diagnosis of malignant pleural mesothelioma (MPM) is challenging and requires immunohistochemistry or electron microscopy assays to specifically differentiate MPM from lung adenocarcinoma. An ultrastructural study of fresh tissue is considered to be the "gold standard." In most cases, the first diagnostic approach is performed on pleural effusion, and in some patients, this is the only available sample for diagnosis. The aim of the present study is to evaluate if an examination of pleural effusion samples based on electron microscopy (EMpe) is a useful tool for the differential diagnosis of MPM and lung adenocarcinoma. An EMpe study was performed in 25 pleural effusion samples. Histological and immunohistochemical markers confirmed the diagnosis of either mesothelioma (5) or adenocarcinoma (20). Of the five cases that were diagnosed with mesothelioma, two samples (40%) showed cells with "bushy" microvilli, which are characteristic of mesothelioma, by EMpe, and three were acellular (60%). Of the 20 cases of adenocarcinoma, EMpe showed cells with short microvilli in 9 (45%), and 11 were acellular (55%). EMpe identifies unequivocal morphological changes that are useful for the differential diagnosis of MPM or adenocarcinoma when the pleural effusion sample contains evaluable tumor cells.
authors.affiliation: a Pathology Department , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Hugo
authors.initials: H
authors.lastname: Domínguez-Malagón
authors.affiliation: a Pathology Department , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Cano-Valdez
authors.affiliation: a Pathology Department , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Carrillo
authors.affiliation: b Thoracic Oncology Unit , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Yelitza Esmeralda
authors.initials: YE
authors.lastname: Campos-Salgado
authors.affiliation: c Radiology Department , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Lara-Garcia
authors.affiliation: b Thoracic Oncology Unit , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Mariana
authors.initials: M
authors.lastname: Lopez-Mejia
authors.affiliation: b Thoracic Oncology Unit , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Jose Francisco
authors.initials: JF
authors.lastname: Corona-Cruz
authors.affiliation: b Thoracic Oncology Unit , Instituto Nacional de Cancerología , Tlalpan , Mexico City , Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Arrieta
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000648:ultrastructure; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D003581:Cytodiagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000648:ultrastructure; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000648:ultrastructure; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000473:pathology*; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000648:ultrastructure
chemical_list: D014408:Biomarkers, Tumor
keywords: Asbestos; electron; immunohistochemistry; lung neoplasms; microscopy; pleural effusion