Contribution of electron microscopy to the diagnosis of pleural mesothelioma

Our plain-English summary of Contribution of electron microscopy to the diagnosis of pleural mesothelioma, by P. Stoebner, J.F. Bernaudin, M. Nebut, et al (Annals of the New York Academy of Sciences, 1979).

The study

• Authors: P. Stoebner, J.F. Bernaudin, M. Nebut, F. Basset
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:751-60
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003990).

Abstract

The contribution of scanning and electron microscopy to the diagnosis of suspected pleural mesotheliomas has been under investigation. The diagnostic value of the scanning electron microscopy has not been found to be decisive in pleural effusions. By contrast, the transmission electron microscopy was of great value, particularly in lesions or tumors composed mainly of spindle cells. The finding of fibroblastoid mesothelial, or transitional cells, alongside typical mesothelial cells is a clue to the diagnosis of mesotheliomas.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This workshop paper from France described how two kinds of electron microscopy, scanning (SEM) and transmission (TEM), could help diagnose pleural mesothelioma when ordinary light microscopy was not conclusive. Drawing on their earlier studies of 25 malignant pleural mesothelioma cases, the authors described three main groups of tumor cells: cells like normal mesothelial cells, spindle-shaped cells like atypical fibroblasts, and 'transitional' (fibroblastoid mesothelial) cells with features of both. They examined tumor tissue from one confirmed case and pleural fluid from three other confirmed cases by SEM, and found it was still difficult to diagnose mesothelioma by SEM alone. They also re-examined preserved specimens from 13 pleural tumors, some unclassified or excluded by the French Mesothelioma Register panel, and described two in detail. On this older material SEM was not very helpful, but TEM gave conclusive results. Image quality depended on how the tissue had been preserved. The authors concluded that characteristic features under the electron microscope could confirm mesothelioma in tumors that looked atypical under light microscopy. The article did not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive pathology methods paper (workshop presentation) with SEM study of 4 confirmed cases and retrospective SEM and TEM examination of 13 archived pleural tumor specimens, two presented as examples
• Who was studied: Pleural tumor specimens in France: tissue from 1 confirmed mesothelioma case and pleural effusions from 3 other confirmed cases (SEM), plus 13 pleural tumors studied retrospectively, some unclassified or excluded by the French Mesothelioma Register Panel; dates not given
• Exposure: The article does not discuss asbestos or any other exposure; it is about diagnostic techniques
• Main results:
  • In the authors' earlier ultrastructural studies of 25 malignant pleural mesothelioma cases (cited, not new data), the tumors were made up of three main groups of cells: epithelial-type mesothelial cells, fusiform (spindle) cells, and transitional (fibroblastoid mesothelial) cells
  • For the confirmed tissue and effusion cases, the authors found it was still difficult to diagnose mesothelioma by SEM alone
  • The authors presented two of the 13 retrospectively studied tumors as examples
  • Case M 219, excluded from the French Mesothelioma Register with a light-microscopy diagnosis of pachypleuritis, showed characteristic features of fibroblastoid mesothelial (transitional) cells on TEM
  • Case 54 XP 78, a pleural tumor stored in formalin for about two years, showed microvilli, microfilaments and junctional systems on TEM, and the diagnosis of mesothelioma was then ascertained
  • In the retrospective material, SEM was not very helpful for diagnosis, while TEM of paraffin-embedded or fixative-stored tissue gave conclusive results
  • Despite variable preservation, it was always possible to tell pachypleuritis apart from purely fibrous mesotheliomas
• The authors' conclusion: The authors concluded that electron microscopy shows characteristic ultrastructural patterns that confirm the diagnosis of mesothelioma in forms that appear atypical under light microscopy
• Limitations the authors state:
  • The quality of electron microscopy on archived tissue depended on preservation: excellent with formalin-stored specimens, only good with paraffin-embedded tissue, poor with other fixatives
  • SEM alone was not sufficient to diagnose mesothelioma

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Scanning Electron Microscopy (SEM), Pleural Effusion, Transmission Electron Microscopy (TEM), Spindle Cell, Mesothelial Cells, Mesothelioma.

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