Asbestos And Immunohistochemical Diagnosis Of Mesothelioma

Asbestos And Immunohistochemical Diagnosis Of Mesothelioma

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One interesting study is called, The role of immunohistochemistry in the diagnosis of malignant mesothelioma. By Moran CA, Wick MR, Suster S. Department of Pathology, The University of Alabama at Birmingham, 35294, USA. Semin Diagn Pathol. 2000 Aug;17(3):178-83. Here is an excerpt: Abstract - The immunohistochemical diagnosis of mesothelioma is perhaps one of the most perplexing and controversial issues in surgical pathology. A tumor that in essence is extremely rare has managed to captivate the attention not only of pulmonologists and thoracic surgeons but also of pathologists. Throughout its history, mesothelioma has emerged as one of the tumors that has evaded definitive characterization; hence, the numerous attempts at trying to establish not only histological criteria but also histochemical, immunohistochemical, and ultrastructural guidelines for its diagnosis. Perhaps as we enter an era of more sophisticated technology, molecular biology will have an opportunity to make inroads into the diagnosis and characterization of this peculiar neoplasm. Despite the many difficulties involved in the diagnosis of malignant mesothelioma, we have recently gained significant knowledge of this entity in many respects, several decades after its description. From a morphological point of view, several variations of the histological appearances that these tumors may exhibit have been described. Traditional histochemistry and electron microscopy continue to play an important role in the evaluation of these neoplasms, with ultrastructural analysis in particular representing the most reliable technique for making this diagnosis in equivocal cases. However, because of its speed, cost-effectiveness, and general availability, immunohistochemistry has emerged as the most commonly used procedure for the diagnosis of mesotheliomas. We herein present a review of the current status of immunohistochemical evaluation of malignant lesions that are suspected of having a mesothelial lineage.

Another interesting study is called, Surgical Management of Malignant Mesothelioma - The Annals of Thoracic Surgery Volume 26, Issue 4, October 1978, Pages 375-382 by iacomo A. DeLaria M.D., Robert Jensik M.D., L. Penfield Faber M.D. and C. Frederick Kittle M.D. - a Department of Cardiovascular-Thoracic Surgery, Rush Cancer Center, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL. Here is an excerpt: Abstract - The surgical management of 18 patients diagnosed as having malignant mesothelioma is reviewed. Of these patients, 7 received limited treatmentpleurectomy or biopsy. The mean survival was 10 months, and no patient was disease-free at time of death. The other 11 patients were treated by radical extrapleural pneumonectomy. There were 2 long-term, disease-free survivors at 2 and 4 years. Mean survival for the entire group was 15 months, but most patients received good palliation following tumor removal.

Surgical procedures for removal of malignant mesothelioma can be accomplished safely and without major morbidity. When possible, radical extrapleural pneumonectomy affords the best palliation and the only opportunity for cure.

Another study is called, Operation and intracavitary photodynamic therapy for malignant pleural mesothelioma: A phase II study - The Annals of Thoracic Surgery Volume 58, Issue 4, October 1994, Pages 995-998 by Hiroshi Takita MD, Thomas S. Mang PhD, Gregory M. Loewen MD, Joseph G. Antkowiak MD, Derek Raghavan MD, PhD, James R. Grajek MBA and Thomas J. Dougherty PhD. Here is an excerpt: Abstract - From April 1991 to May 1993,23 patients entered a phase II clinical study of surgical resection and adjuvant intracavitary photodynamic therapy for malignant pleural mesothelioma. Two days preoperatively, patients received an intravenous injection of 2 mg/kg of the photosensitizer Photofrin. Six patients underwent a pleuropneumonectomy, and 15 patients a pleurectomy, after which intracavitary photodynamic therapy was administered. A total light energy dose of 20 to 25 J/cm2 was given. In 2 patients the tumor was unresectable due to intrapericardial invasion. Postoperative complications were noted in more than 50 percent of patients; 2 patients died of postoperative complications. Postoperative survival was analyzed according to intraoperative staging proposed by the American Joint Committee for Cancer Staging, published in 1992. The overall estimated median survival is 12 months; that of stage III and IV patients is 7 months. Five patients with stage I and II diseases (who had grossly complete resection by pleurectomy) are alive, disease-free, for 11, 17, 18, 21, and 33 postoperative months. Intraoperative staging is important in carrying out further clinical studies of malignant pleural mesothelioma.

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Monty Wrobleski is the author of this article. For more information please click on the following links



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