Ultrastructural features of diffuse malignant mesotheliomas

Our plain-English summary of Ultrastructural features of diffuse malignant mesotheliomas, by T.D. Oury, S.P. Hammar, V.L. Roggli (Human Pathology, 1998).

The study

• Authors: T.D. Oury, S.P. Hammar, V.L. Roggli
• Journal: Human Pathology
• Published: 1998;29(12):1382-92
• Type of article: Review
• Cited by: 45 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The distinction of malignant mesothelioma from tumors metastatic to the serosal membranes can often be made based on the results of histochemical or immunohistochemical studies. However, in some cases, these techniques are inadequate to make a firm diagnosis. In these instances, electron microscopic studies with the observation of a constellation of characteristic ultrastructural findings may permit an unequivocal diagnosis of mesothelioma.

In plain English

This article was a review, not an original study. The authors described how pathologists tell malignant mesothelioma apart from other tumors, especially adenocarcinoma, using stains, immunohistochemistry and electron microscopy. They did not study patients themselves, and they did not discuss asbestos exposure. The study results they described came from earlier published studies, which they cited. The authors wrote that no ultrastructural feature is unique to mesothelioma, but several are characteristic, including long, thin surface microvilli. In one cited report, 25 of 27 epithelial mesotheliomas had microvilli with a length-to-diameter ratio greater than 10, compared with zero of 18 adenocarcinomas. The cited studies also found more tonofilaments (intracellular filament bundles) in mesotheliomas than in adenocarcinomas. On cost, the authors gave electron microscopy as $400 to $500 and immunohistochemistry as $90 to $135 per antibody. They described a break-even point at about 4 to 5 antibodies. The authors concluded that electron microscopy can resolve, most of the time, difficult cases that staining methods cannot settle.

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: Narrative review of published research on the ultrastructural (electron microscope) features of diffuse malignant mesothelioma and how they differ from other tumors
• Who was studied: No patients were studied by the authors. The review drew on published studies comparing mesotheliomas with adenocarcinomas and other tumors.
• Main results:
  • The authors stated that no ultrastructural features are unique to malignant mesotheliomas. Features they described as characteristic include abundant intermediate filaments, long surface microvilli and often prominent accumulations of glycogen.
  • A cited report by Roggli et al found that 25 of 27 (93%) malignant epithelial mesotheliomas had microvilli with a length-to-diameter ratio greater than 10, compared with zero of 18 adenocarcinomas.
  • A cited study by Dewar et al found microvilli in direct contact with collagen through gaps in the basement membrane in 10 of 12 epithelial mesotheliomas. None of the 20 adenocarcinomas examined showed this.
  • Cited studies by Warhol et al found that mesotheliomas contain significantly more tonofilaments than adenocarcinomas of the lung, breast, ovary and endometrium.
  • Dense-core neuroendocrine granules have been seen in some carcinomas but, according to the authors, have not been reported in mesotheliomas.
  • The authors gave electron microscopy as costing $400 to $500 and immunohistochemistry $90 to $135 per antibody, with a break-even point at approximately 4 to 5 antibodies.
  • A cited study by Frost et al, covering neoplasms evaluated by both methods, found electron microscopy helpful more often (92%) than immunohistochemistry (72%) in making a final diagnosis.
• The authors' conclusion: The authors concluded that staining methods are often enough to diagnose malignant mesothelioma. When they are not, they concluded, the ultrastructural characteristics of mesothelioma allow electron microscopy to resolve these difficult cases most of the time.

Topics

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

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

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• Diffuse epithelial mesothelioma: a review of the ultrastructural spectrum — I. Dardick, M. Jabi, et al. (1987)
• Molecular and Ultrastructural Features of Diffuse Intrapulmonary Malignant Mesothelioma — B.T. Larsen, M.L. Smith, et al. (2019)
• Histochemical and ultrastructural features of an unusual pulmonary carcinosarcoma — K.G. Zimmerman, R.E. Sobonya, et al. (1981)
• Adenomatoid tumour of the epididymis: histochemical and ultrastructural study of 2 cases — M. Nistal, F. Contreras, et al. (1978)
• An ultrastructural comparison of mesotheliomas with adenocarcinomas of the lung and breast — M.J. Warhol, J.M. Corson (1985)

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