Pathologic Diagnosis of Mesothelioma

作者：David B. Chapel, Aliya N. Husain, Thomas Krausz · 年份：2024 · DOI：10.1201/9781003431909-11 · 被引用次数：1 · 研究领域：Occupational and environmental lung diseases

Diagnosis of mesothelioma remains a challenge for surgical pathologists in both general and subspecialized practice. Morphology is the cornerstone of pathologic diagnosis. However, the development and refinement of robust immunohistochemical stains to confirm mesothelial lineage and, more significantly, to detect malignancy-defining pathogenic molecular alterations in BAP1 , CDKN2A , NF2 , and TP53 have significantly altered diagnostic practice, permitting more confident diagnosis in morphologically challenging cases, including small biopsies and effusion cytology preparations. These powerful tools have also revived the concept of mesothelioma in situ, raising the hope for earlier diagnosis and meaningful early interventions. More robust molecular techniques, including next-generation sequencing panels, are already in routine diagnostic use in some institutions. This growing arsenal must be applied in the context of a differential diagnosis generated through rigorous morphologic evaluation, and the composite pathologic results should be interpreted alongside clinical and radiographic data, ideally in the form of a multidisciplinary tumor board.