On the diagnosis of malignant pleural mesothelioma: a necropsy-based study of 171 cases (1997-2016)

Our plain-English summary of On the diagnosis of malignant pleural mesothelioma: a necropsy-based study of 171 cases (1997-2016), by P.G. Barbieri (Tumori, 2019).

The study

• Author: P.G. Barbieri
• Journal: Tumori
• Published: 2019;105(4):361-362
• Read it: PubMed · Publisher

In plain English

This item is a letter to the editor, not a full research article. In it, the author replied to comments by Pira et al. about an earlier necropsy (autopsy) study of 171 cases of malignant pleural mesothelioma from 1997 to 2016. The letter reported that 126 of the 171 autopsy cases had biopsies, and 91 also had immunohistochemistry (IHC), a laboratory staining test used to tell mesothelioma apart from other tumors. Of those 91, 60 (65.9%) were stained with at least 2 mesothelioma markers and 2 markers of carcinoma or other tumors. Another 23 (25.3%) had at least 2 mesothelioma markers and 1 other marker. The author did not consider IHC a strong requirement for confirming the diagnosis. The author cited expert guidelines that place staining results alongside other pathology, clinical and imaging findings, and argued that autopsy is well suited to showing how the tumor has spread. The author noted that the study was not experimental and that the autopsy assessment was not blind to each case's history. The letter did not report on 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: Letter to the editor (correspondence) replying to comments on the author's earlier necropsy-based case series
• Who was studied: 171 autopsy cases of malignant pleural mesothelioma from the earlier study (1997 to 2016). 126 had biopsies and 91 also had immunohistochemistry
• Exposure: Not addressed. The letter concerns diagnostic methods (immunohistochemical staining), not asbestos exposure
• Main results:
  • Of the 91 cases with immunohistochemistry, 60 (65.9%) were stained with at least 2 mesothelioma markers and 2 markers of carcinoma or other neoplasms
  • Of the 91 cases, 23 (25.3%) had at least 2 mesothelioma markers and 1 marker of carcinoma or other neoplasms
  • Of the 91 cases, 1 (1.1%) had 1 mesothelioma marker and at least 2 other markers, 4 (4.4%) had at least 2 mesothelioma markers but no other markers, and 3 (3.3%) had immunohistochemistry carried out but no detailed results available
• The authors' conclusion: The author did not consider immunophenotypization (IHC) a strong requirement for confirming the diagnosis. The author argued that the distribution of the tumor is central to diagnosis and that autopsy is well suited to assessing it
• Limitations the authors state:
  • The results were not obtained through an experimental design, and assessment at autopsy was not blind to each case's clinical and pathologic history
  • The study originated in a criminal trial for manslaughter in which the author served as expert witness for the public prosecution office. The original article stated this as a potential source of conflicting interest, although the letter's own declaration says there is no conflict of interest

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Autopsy.

Related studies

• On the diagnosis of malignant pleural mesothelioma: A necropsy-based study of 171 cases (1997-2016) — E. Pira, P. Boffetta, et al. (2019)
• Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group — A.N. Husain, T.V. Colby, et al. (2018)
• Downregulated microRNAs in the differential diagnosis of malignant pleural mesothelioma — G.V. Gee, D.C. Koestler, et al. (2010)
• Cytological differential diagnosis among adenocarcinoma, epithelial mesothelioma, and reactive mesothelial cells in serous effusions by immunocytochemistry — X.Y. Su, G.D. Li, et al. (2011)
• Value of Glut-1 and Koc markers in the differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and pulmonary adenocarcinoma — Ö. Üçer, A.F. Dağli, et al. (2013)
• The Role of CD90 in the Differential Diagnosis of Pleural Malignant Mesothelioma, Pulmonary Carcinoma and Comparison with Calretının — N. Sahin, A.N. Akatli, et al. (2017)

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