Immunopathology of malignant mesothelioma

Our plain-English summary of Immunopathology of malignant mesothelioma, by K. Sheibani (Human Pathology, 1994).

The study

• Author: K. Sheibani
• Journal: Human Pathology
• Published: 1994;25(3):219-20
• Type of article: Comment, Editorial
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This editorial discussed the use of immunopathology to tell malignant mesothelioma apart from adenocarcinoma involving the pleura or peritoneum. It accompanied a study by Zeng et al in the same issue. The author noted that clinical and radiologic findings may not always help, that not all adenocarcinomas are mucin positive, and that the ultrastructural features of mesothelioma seen by electron microscopy are usually found only in well-differentiated epithelial tumours. He summarised Zeng et al's findings: all the human mesothelioma cell lines they studied reacted strongly with anticytokeratin and vimentin, and none expressed factor VIII, CEA or Leu-M1. In the author's experience, a panel of keratin, Leu-M1, Ber-EP4 and CEA was the most useful and cost-effective, though occasional cases needed more markers. Keratin staining helped separate sarcomatoid mesothelioma from keratin-negative sarcomas but not epithelial mesothelioma from adenocarcinoma. Leu-M1 staining was often focal, which could cause problems in small biopsies. In an earlier series, Ber-EP4 was expressed in 87% of adenocarcinomas but showed focal reactivity in only one of 115 mesotheliomas. The author also commented on CEA antibodies, the K-1 antibody, DNA ploidy analysis and experimental genetic markers. He concluded that until a mesothelioma-specific marker is identified, mesothelioma will remain a diagnosis of exclusion. The editorial did not discuss asbestos exposure.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article is a short editorial (commentary), not an original study. It discussed how pathologists can tell malignant mesothelioma apart from adenocarcinoma, another cancer, when it involves the pleura or peritoneum. It also introduced a study of mesothelioma cell lines by Zeng and colleagues published in the same journal issue. The article did not discuss asbestos exposure. Drawing on the author's own experience and published work, the author stated that a panel of antibody stains for keratin, Leu-M1, Ber-EP4 and CEA appeared to be the most useful and practical panel. The author wrote that keratin staining has little or no practical value for telling epithelial mesothelioma from adenocarcinoma. Leu-M1 staining is usually patchy, which can be a problem in small biopsies. With monoclonal antibodies, CEA is found in most adenocarcinomas and is absent in mesothelioma. The author concluded that until a marker specific to mesothelioma is found, mesothelioma will remain a diagnosis of exclusion, meaning other tumors must be ruled out.

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: Editorial commentary introducing another study in the same journal issue (Zeng et al), drawing on the author's experience and published work; not an original study
• Who was studied: No study population; the editorial concerns the diagnostic distinction between malignant mesothelioma and adenocarcinoma involving the pleura or peritoneum
• Main results:
  • In the author's experience, an antibody panel of keratin, Leu-M1, Ber-EP4 and CEA appears to be the most useful, efficient, cost-effective and practical panel when mesothelioma is among the possible diagnoses
  • The author stated that keratin staining has little or no practical value for distinguishing epithelial mesothelioma from adenocarcinoma, because both are keratin positive
  • The author noted that Leu-M1 staining is usually focal (patchy), which can be a problem in small biopsy specimens or cytologic preparations
  • The author stated that, when monoclonal antibodies are used, CEA is found in the majority of adenocarcinomas and is absent in mesothelioma
  • The author stated that several years of experience with Ber-EP4 showed it to be a useful discriminant
• The authors' conclusion: The author concluded that until a mesothelioma-specific antigen or genetic marker is identified, the diagnosis of mesothelioma will remain a diagnosis of exclusion

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: Malignant Mesothelioma, Adenocarcinoma, Pleura, Peritoneum, Mesothelioma, Well-Differentiated, Ber-EP4, Sarcomatoid.

Related studies

• Increasing role of immunopathology in diagnosis of malignant mesothelioma — K. Sheibani (1997)
• Fluorescence in situ hybridization (FISH) provides estimates of minute and interstitial BAP1, CDKN2A, and NF2 gene deletions in peritoneal mesothelioma — S. Brich, F. Bozzi, et al. (2020)
• Mesotheliomas induced in rats by the fibrous mineral erionite are independent from p53 alterations — E.V. Kleymenova, G. Horesovsky, et al. (1999)
• Gene therapy using adenovirus carrying the herpes simplex-thymidine kinase gene to treat in vivo models of human malignant mesothelioma and lung cancer — H.C. Hwang, W.R. Smythe, et al. (1995)
• Potentiation of cisplatin and carboplatin cytotoxicity by amphotericin B in different human ovarian carcinoma and malignant peritoneal mesothelioma cells — L. Poulain, F. Sichel, et al. (1997)
• Oncolytic vaccinia virus as an adjuvant treatment to cytoreductive surgery for malignant peritoneal mesothelioma — S.A. Acuna, K. Ottolino-Perry, et al. (2014)

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