Guidelines for pathologic diagnosis of Malignant Mesothelioma

2017 Update of the consensus statement from the International Mesothelioma Interest Group

Aliya Noor Husain, Thomas V. Colby, Nelson G. Ordóñez, Timothy Craig Allen, Richard Luther Attanoos, Mary Beth Beasley, Kelly Jo Butnor, Lucian R. Chirieac, Andrew M. Churg, Sanja Dacic, Françoise Galateau-Sallé, Allen Gibbs, Allen M. Gown, Thomas Krausz, Leslie Anne Litzky, Alberto Marchevsky, Andrew G. Nicholson, Victor Louis Roggli, Anupama K. Sharma, William D. Travis & 2 others Ann E. Walts, Mark R. Wick

Research output: Contribution to journalReview article

84 Citations (Scopus)

Abstract

Context.-Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose. Objective.-To provide updated, practical guidelines for the pathologic diagnosis of MM. Data Sources.-Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks. Conclusions.-There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohisto-chemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.

Original languageEnglish (US)
Pages (from-to)89-108
Number of pages20
JournalArchives of Pathology and Laboratory Medicine
Volume142
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Public Opinion
Mesothelioma
Guidelines
Differential Diagnosis
Malignant Mesothelioma
Coloring Agents
Epithelioid Cells
Textbooks
Information Storage and Retrieval
Differentiation Antigens
Renal Cell Carcinoma
Publications
Electron Microscopy
Adenocarcinoma
Epithelial Cells
Staining and Labeling
Breast Neoplasms

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Guidelines for pathologic diagnosis of Malignant Mesothelioma : 2017 Update of the consensus statement from the International Mesothelioma Interest Group. / Husain, Aliya Noor; Colby, Thomas V.; Ordóñez, Nelson G.; Allen, Timothy Craig; Attanoos, Richard Luther; Beasley, Mary Beth; Butnor, Kelly Jo; Chirieac, Lucian R.; Churg, Andrew M.; Dacic, Sanja; Galateau-Sallé, Françoise; Gibbs, Allen; Gown, Allen M.; Krausz, Thomas; Litzky, Leslie Anne; Marchevsky, Alberto; Nicholson, Andrew G.; Roggli, Victor Louis; Sharma, Anupama K.; Travis, William D.; Walts, Ann E.; Wick, Mark R.

In: Archives of Pathology and Laboratory Medicine, Vol. 142, No. 1, 01.01.2018, p. 89-108.

Research output: Contribution to journalReview article

Husain, AN, Colby, TV, Ordóñez, NG, Allen, TC, Attanoos, RL, Beasley, MB, Butnor, KJ, Chirieac, LR, Churg, AM, Dacic, S, Galateau-Sallé, F, Gibbs, A, Gown, AM, Krausz, T, Litzky, LA, Marchevsky, A, Nicholson, AG, Roggli, VL, Sharma, AK, Travis, WD, Walts, AE & Wick, MR 2018, 'Guidelines for pathologic diagnosis of Malignant Mesothelioma: 2017 Update of the consensus statement from the International Mesothelioma Interest Group', Archives of Pathology and Laboratory Medicine, vol. 142, no. 1, pp. 89-108. https://doi.org/10.5858/arpa.2017-0124-RA
Husain, Aliya Noor ; Colby, Thomas V. ; Ordóñez, Nelson G. ; Allen, Timothy Craig ; Attanoos, Richard Luther ; Beasley, Mary Beth ; Butnor, Kelly Jo ; Chirieac, Lucian R. ; Churg, Andrew M. ; Dacic, Sanja ; Galateau-Sallé, Françoise ; Gibbs, Allen ; Gown, Allen M. ; Krausz, Thomas ; Litzky, Leslie Anne ; Marchevsky, Alberto ; Nicholson, Andrew G. ; Roggli, Victor Louis ; Sharma, Anupama K. ; Travis, William D. ; Walts, Ann E. ; Wick, Mark R. / Guidelines for pathologic diagnosis of Malignant Mesothelioma : 2017 Update of the consensus statement from the International Mesothelioma Interest Group. In: Archives of Pathology and Laboratory Medicine. 2018 ; Vol. 142, No. 1. pp. 89-108.
@article{787737a6ce1e4be8b3724e0f8cbe7cce,
title = "Guidelines for pathologic diagnosis of Malignant Mesothelioma: 2017 Update of the consensus statement from the International Mesothelioma Interest Group",
abstract = "Context.-Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose. Objective.-To provide updated, practical guidelines for the pathologic diagnosis of MM. Data Sources.-Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks. Conclusions.-There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohisto-chemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80{\%} for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10{\%} is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.",
author = "Husain, {Aliya Noor} and Colby, {Thomas V.} and Ord{\'o}{\~n}ez, {Nelson G.} and Allen, {Timothy Craig} and Attanoos, {Richard Luther} and Beasley, {Mary Beth} and Butnor, {Kelly Jo} and Chirieac, {Lucian R.} and Churg, {Andrew M.} and Sanja Dacic and Fran{\cc}oise Galateau-Sall{\'e} and Allen Gibbs and Gown, {Allen M.} and Thomas Krausz and Litzky, {Leslie Anne} and Alberto Marchevsky and Nicholson, {Andrew G.} and Roggli, {Victor Louis} and Sharma, {Anupama K.} and Travis, {William D.} and Walts, {Ann E.} and Wick, {Mark R.}",
year = "2018",
month = "1",
day = "1",
doi = "10.5858/arpa.2017-0124-RA",
language = "English (US)",
volume = "142",
pages = "89--108",
journal = "Archives of Pathology and Laboratory Medicine",
issn = "0003-9985",
publisher = "College of American Pathologists",
number = "1",

}

TY - JOUR

T1 - Guidelines for pathologic diagnosis of Malignant Mesothelioma

T2 - 2017 Update of the consensus statement from the International Mesothelioma Interest Group

AU - Husain, Aliya Noor

AU - Colby, Thomas V.

AU - Ordóñez, Nelson G.

AU - Allen, Timothy Craig

AU - Attanoos, Richard Luther

AU - Beasley, Mary Beth

AU - Butnor, Kelly Jo

AU - Chirieac, Lucian R.

AU - Churg, Andrew M.

AU - Dacic, Sanja

AU - Galateau-Sallé, Françoise

AU - Gibbs, Allen

AU - Gown, Allen M.

AU - Krausz, Thomas

AU - Litzky, Leslie Anne

AU - Marchevsky, Alberto

AU - Nicholson, Andrew G.

AU - Roggli, Victor Louis

AU - Sharma, Anupama K.

AU - Travis, William D.

AU - Walts, Ann E.

AU - Wick, Mark R.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Context.-Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose. Objective.-To provide updated, practical guidelines for the pathologic diagnosis of MM. Data Sources.-Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks. Conclusions.-There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohisto-chemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.

AB - Context.-Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose. Objective.-To provide updated, practical guidelines for the pathologic diagnosis of MM. Data Sources.-Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks. Conclusions.-There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohisto-chemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.

UR - http://www.scopus.com/inward/record.url?scp=85039034094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039034094&partnerID=8YFLogxK

U2 - 10.5858/arpa.2017-0124-RA

DO - 10.5858/arpa.2017-0124-RA

M3 - Review article

VL - 142

SP - 89

EP - 108

JO - Archives of Pathology and Laboratory Medicine

JF - Archives of Pathology and Laboratory Medicine

SN - 0003-9985

IS - 1

ER -