Güncel Patoloji Dergisi 2017 , Vol 1 , Num 3
MALİGNANT MESOTHELİOMA ? A DİAGNOSTİC CHALLENGE
Lutz Welker1, Hatice Elmas1, Florian Stellmacher2
1Cytological Laboratory, Lungenclinic Grosshansdorf, Wöhrendamm 80, D-22927 Grosshansdorf, Germany; Airway Research Center Nort (arcn), German Center For Lung Research (dzl).
2Research Center Borstel, Clinical And Experimental Pathology, Parkallee 1-40, D-23845 Borstel, Germany; Airway Research Center Nort (arcn), German Center For Lung Research (dzl).

Özet

Objectives: The histologic diagnosis of malignant pleural mesothelioma (MM) seems to be well established. In contrast to histology the suitability and accuracy of cytology as well as the analysis of Hyaluronic Acid (HA) remains controversial [1,2].

Materials and Methods: Between 2000 and 2010 the outcome of cyto-/histo­logical diagnosis were analyzed separately and in combination with HA values. Overall 5122 biopsies of 3158 patients (3526 pleural effusions, 1133 cytologic touch preparations and 251 fine needle aspirations) were analyzed.

Results: The final diagnoses of 2979 specimens (1511 benign, 1132 malignant lesions, and 37 findings suspicious of tumour) were verified histologically. In 354 of 485 MM the final diagnosis could be verified by histology, in 444 cases by cytology alone, and in 579 cases using combination of cyto-/histologic analysis. In 321 of 900 MM it was not possible to confirm the diagnosis MM. HA analysis demonstrated 130 values above the cut-off value of 30mg/L for MM.

Conclusions: In summary the combination of cyto-/histologic evaluation supplemented by the results of HA analysis demon-strated a slightly reduced sensitivity from 72.7 to 69.1%, whereas specificity was unchanged (99.5 vs. 99.6%). These procedure seems to be suitable to improve the safety of MM diagnosis.

References:

1. Husain AN, Colby T, Ordonez N et al. Guidelines for pathologic diagnosis of malignant meso­thelioma: A Consensus Statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med. 2009;133:1317–1331

2. Ascoli V Pathologic diagnosis of malignant mesothelioma: chrono­logical prospect and advent of recommendations and guidelines. Ann Ist Super Sanità 2015; 51(1):52-59.