Exfoliative cytology of diffuse mesothelioma

Our plain-English summary of Exfoliative cytology of diffuse mesothelioma, by G.H. Roberts, G.M. Campbell (Journal of Clinical Pathology, 1972).

The study

• Authors: G.H. Roberts, G.M. Campbell
• Journal: Journal of Clinical Pathology
• Published: 1972;25(7):577-82
• Cited by: 50 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The exfoliative cytology of 14 diffuse mesothelioma (11 pleural and three peritoneal) is described. Malignant cells were identified in 10 patients; in eight malignant cells still retaining the characteristics of mesothelial cells were found. It is suggested that only if malignant cells of this type are recognized should the probable diagnosis of diffuse mesothelioma be made.

In plain English

This article was a case series from the Pathology Department of the Southern General Hospital in Glasgow. The authors described the cells found in fluid samples from 14 patients with diffuse mesothelioma: pleural fluid from 11 patients with pleural mesothelioma and ascitic (abdominal) fluid from three patients with peritoneal mesothelioma. The article did not study asbestos exposure; the authors noted that exposure had been described in earlier papers. Malignant cells were found in 10 of the 14 patients. In eight, the malignant cells still had the features of mesothelial cells. In three of these eight, the fluid findings were what first suggested probable mesothelioma. In two other patients, the malignant cells showed no mesothelial features. No definite malignant cells were found in four patients, two of whom had tumours of the mesenchymal type. The authors considered unusual-looking ('atypical') mesothelial cells to be of limited diagnostic value. To avoid false positive reports, they suggested making a 'probable' diagnosis of mesothelioma only when cells with malignant nuclei and mesothelial features were present.

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 case series of fluid cytology (exfoliative cytology) in patients with mesothelioma
• Who was studied: 14 patients with diffuse mesothelioma (11 pleural, 3 peritoneal) seen at the Southern General Hospital, Glasgow. Cases 1-8 came from a series of 20 pleural mesotheliomas seen in 1950-67. Cases 9-11 came from a series of four peritoneal mesotheliomas seen in the last four years. Cases 12-14 were pleural mesotheliomas seen within the last two years.
• Exposure: Asbestos exposure was not studied in this article. The authors state that the relation to asbestos exposure had been described in earlier papers.
• Main results:
  • Malignant cells were identified in 10 of the 14 patients. In 8 of them, the malignant cells retained the characteristics of mesothelial cells.
  • In cases 9 and 11 (peritoneal) and case 14 (pleural), the initial diagnosis of probable mesothelioma was suggested from these cells. When earlier cases were reviewed, similar cells were found in four more pleural cases (1, 3, 6, 8) and one more peritoneal case (10).
  • In two pleural cases (cases 4 and 13), malignant cells were seen but showed no mesothelial characteristics.
  • In two pleural cases (cases 5 and 12), no definite malignant cells were identified, and the smears were reported as suspicious of secondary carcinoma.
  • No malignant cells were found in the pleural fluid of two patients (cases 2 and 7) whose mesothelioma was found at necropsy to be of mesenchymal type.
  • Smears from 13 cases contained moderate or numerous mesothelial cells. Some of these looked benign and others looked 'atypical'.
• The authors' conclusion: To avoid an unacceptable number of false positive reports, the authors suggested that a 'probable' diagnosis of mesothelioma be made only when cells with malignant nuclei and the other characteristics of mesothelial cells are present.
• Limitations the authors state:
  • For the clusters of malignant cells, the authors could be more certain that the cells were malignant than that they came from mesothelium.
  • The authors judged that atypical mesothelial cells have limited value in diagnosing mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Cytology, Mesothelioma, Mesothelial Cells.

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