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Malignant pleural mesothelioma: Clinicopathology of 16 extrapleural pneumonectomy patients with special reference to early stage features
Author(s) -
Hiroshima Kenzo,
Yusa Toshikazu,
Kameya Toru,
Ito Ichiro,
Kaneko Kou,
Kadoyama Chikabumi,
Kishi Hirohisa,
Saitoh Yukio,
Ozaki Daisuke,
Itami Makiko,
Iwata Takekazu,
Iyoda Akira,
Kawai Toshiaki,
Yoshino Ichiro,
Nakatani Yukio
Publication year - 2009
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2009.02404.x
Subject(s) - mesothelioma , parietal pleura , extrapleural pneumonectomy , pathology , medicine , mesothelium , mesothelial cell , stage (stratigraphy) , pneumonectomy , lung , lung cancer , biology , paleontology
The earliest pathological events in the development of malignant pleural mesothelioma (MPM) are not understood. The aim of the present study was to elucidate the early histopathological features of MPM. A total of 16 extrapleural MPM pneumonectomy patients were investigated. Early stage mesothelioma was arbitrarily defined as a tumor ≤5 mm in thickness regardless of the nodal status or other organ involvement. Eight of these patients (six with epithelioid, two with biphasic) had early stage mesothelioma by this definition. Macroscopically there was no visible tumor, but the parietal and visceral pleura were thickened and there was focal adhesion between them. Microscopically, the mesothelioma lesions were multifocal and discontinuous on the pleura. In extremely early cases of epithelioid mesothelioma, tumor cells were generally arrayed in a single layer, but papillary proliferation was observed elsewhere. In sarcomatoid mesothelioma, mesothelioma cells proliferated, forming multiple small polypoid nodules on the pleura. Epithelial membrane antigen was helpful to distinguish reactive from neoplastic mesothelium, but glucose transporter‐1 was not. Mesothelioma cells disseminate diffusely throughout the parietal and visceral pleura and mediastinal fat tissue before becoming visible. Stage Ia mesothelioma (neoplasm limited to the parietal pleura) would not be observed in daily practice.