Eugene J. Mark, M.D. Professor of Pathology Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts, U.S.A.

Size: px
Start display at page:

Download "Eugene J. Mark, M.D. Professor of Pathology Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts, U.S.A."

Transcription

1 DIFFUSE MALIGNAT MESOTHELIOMAS: AN APPROACH TO DIAGNOSIS EMPHASIZING HEMATOXYLIN-EOSIN AND HISTORICAL ISSUES EMPHASIZING ASBESTOS Texas Society of Pathologists Dallas, Texas 14 January 2011 Eugene J. Mark, M.D. Professor of Pathology Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts, U.S.A. 1

2 36 year-old construction worker with chest pain, dysphagia, and pleural and mediastinal calcifications New Engl J Med

3 Progressive pleural calcification/ossification Asbestos exposure, hemothorax, TB empyema Metastatic osteosarcoma Primary pleural osteosarcoma Parosteal osteosarcoma of the rib Mesothelioma Metastatic calcification of hyperparathyroidism Myositis ossificans and secondary osteosarcoma Pleural biopsy Abnormal bone 3

4 Autopsy Malignant tumor surrounding aorta. DMM in pleura and growing down septa DMM, forming bone and growing from pleura into walls of alveoli. 4

5 DMM, spindled cells at leading edge of bone. 5

6 6

7 DIFFUSE MALIGNANT MESOTHELIOMA : CHANGING CRITERIA FOR DIAGNOSIS 1 A definite diagnosis requires pathological examination, because carcinomas can cause pseudomesotheliomatous carcinomatosis indistnguishable on x-ray even in a patient wasting away from malignancy. Macroscopic (autopsy or surgery) : Tumor is based on the pleura and no other tumor is identified. Microscopic : Tumor spreads upon the serosa. Microscopic : Histologic pattern is biphasic (epithelioid and mesenchymal). DIFFUSE MALIGNANT MESOTHELIOMA : CHANGING CRITERIA FOR DIAGNOSIS 2 Histochemistry : Cells stain negatively with mucicarmine or with periodic-acid Schiff after digestion with diastase. Electron microscopy : Epithelioid cells have long microvilli. Immunochemistry : Cells stain (or not not stain) with a succession of immunochemical reagents. Molecular markers under investigation. Diffuse malignant mesothelioma 7

8 Pleural space embryology - Schizocoelom. DIFFUSE MALIGNANT MESOTHELIOMA DERIVES FROM SCHIZOCOELOM: Biphasic 40%, Epithelioid 50%, Mesenchymal 10% Epithelioid predominates Squamoid Tubuloalveolar Papillary Signet ring Anaplastic (pleomorphic) Mesenchymal predominates Granulomatous Myxoid Angiosarcomatous Fibrosarcomatous Desmoplastic BIPHASIC PLEURAL TUMORS Metastatic sarcomatoid carcinoma of the lung. Metastatic renal cell carcinoma (primary overlooked because thoracic symptom predominate). Metastatic malignant melanoma. Synovial sarcoma. 8

9 DIFFUSE MALIGNANT MESTHELIOMA: GROUND RULES FOR PATHOLOGISTS The most important differential diagnosis is reactive or malignant. Because of the ominous prognosis and paucity of therapy for diffuse malignant mesothelioma, the diagnosis should not be rushed. If there is doubt at any stage, one may need to request another specimen (pleural fluid, needle biopsy, thoracoscopic biopsy, open biopsy, stripping, decortication, pneumonectomy, autopsy). Asbestos history does not define a pathological diagnosis. DIFFUSE MALIGNANT MESOTHELIOMA: SEQUENTIAL ANALYSIS 1. Assurance of malignancy. 2. Mesothelioma vs. Carcinoma. 3. Histologic type of mesothelioma (epithelioid has slightly better prognosis). 4. No rush to diagnosis, because natural history is so little altered by therapy. 5. This pathology can be seen in patients who subsequently develop mesothelioma. 9

10 REACTIVE PLEURITIS: HELPFUL FEATURES TO SUGGEST NOT MALIGNANT Abundant organizing fibrin. Syncytial mesothelial cells in fibrin. Capillaries perpendicular to serosal surface. Collagen bundles all parallel (not storiform). Mixed pattern part clearly reactive, part uncertain. Reference: Kradin RL, Mark EJ: Distinguishing benign mesothelial hyperplasia from neoplasia: a practical approach. Sem Diagn Pathol 2006; 23:4-14. Organizing fibrinous pleuritis, with capillaries perpendicular to surface. DIFFUSE MALIGNANT MESOTHELIOMA IN SITU 1. Biologically a preinvasive phase must exist. 2. For a serosal tumor, surface spread may be as important clinically as invasive to collagen or into vessels. 3. The pleura does not have a basement membrane. 10

11 DMM In situ. Diffuse malignant mesothelioma, tubuloglandular beneath fibrin DMM Superficially invasive. 11

12 Diffuse malignant mesothelioma squamoid. DMM HELPFUL RULE #1 In distinction to metastatic carcinoma, epithelioid cells of DMM are relatively regular in size and shape and chromaticity at the time of the first biopsy, which accounts for the rarity of a positive cytology on the first specimen. As with many other tumors, cellular pleomorphism increases over time. 12

13 DMM HELPFUL RULE #2 The more numerous are distinctive patterns, so more likely is the diagnosis of DMM and not carcinoma or sarcoma. DMM, micropapillae DMM Micropapillary. in patulous space. DMM Papillary with hyaline core. 13

14 Diffuse malignant mesothelioma myxoid with papillary formation. DMM Adenomatoid pattern. DMM - Lymphangiomatoid 14

15 DMM - Glomeruloid. DMM Long thin microvilli. DMM Small cell. 15

16 DMM Septal spread. Diffuse malignant mesothelioma fibrosarcomatous invasive of fat, with storiform formation. DMM Cotyledon. 16

17 DMM - Cambium. DMM Villous-like. DMM Extensive myxoid stroma. 17

18 DMM Microcystic. Diffuse malignant mesothelioma, desmoplastic. DIFFUSE MALIGNANT MESOTHELIOMA: THREE CLASIC DEFINING FEATURES OF MALIGNANCY 1. Necrosis. 2. Storiform pattern. 3. Invasion. 18

19 DESMOPLASTIC DIFFUSE MALIGNANT MESOTHELIOMA: PITFALLS Chronic, well organized effusion. Fibrosing mediastinitis. Metastases as fibrous nodules in bone. Pleural hyaline plaque. Hyaline plaque covered by DMM. ROLE OF IMMUNOCHEMICAL STAINS To assist in defining mesothelial origin (epithelioid forms). To assist in defining depth of the mesothelial cells (i.e., invasion). If not DMM, to assist in defining primary site of metastatic carcinoma (lung -TTF; breast - estrogen receptor, colon CDX2, CK 7, CK 20). No stain is by itself diagnostic. These stains do not distinguish benign from malignant, except as an aid to assessing invasion. The diagnosis of DMM is evident without special studies in many cases. 19

20 IMMUNOCHEMICAL STAINS MOST COMMONLY EMPLOYED CURRENTLY AT MGH FOR DMM v. CARCINOMA Toward mesothelial Calretinin CK 5/6 Wilm s tumor-1 D240 Not useful: Other keratins Toward epithelial TTF-1 (for lung) Napsin CEA Leu M-1 B72.3 MOC 31 Not routine: Thrombomodulin EMA IMMUNOCHEMICAL STAINS MOST COMMONLY EMPLOYED CURRENTLY AT MGH FOR SARCOMATOID DMM v. FIRBOSIS Toward mesothelial Pancytokeratin Toward fibrous reaction Actin Not routine or not helpful Calretinin Wilm s tumor-1 D240 DIFFUSE MALIGNANT MESOTHELIOMA: Recent reviews of immunopathology Klebe S. et. al. Diagnosis of epithelial mesothelioma using treebased regression analysis and a minimal panel of antibodies. Pathology (Australia) 2009; 41: Kao S et. al. Validation of a minimal panel of antibodies for the diagnosis of malignant pleural mesothelioma. Pathology (Australia) 2011; 43: Overall, we at MGH tend to use calretinin, D240, and CK 5/6 as mesothelial markers as well as electron microscopy in epithelioid forms with inconstant immunophemotype. Mesenchymal (desmoplastic) tumors may have all negative markers. 20

21 TUMOR MARKERS FOR DIAGNOSIS AND TREATMENT BY GENE EXPRESSION PROFILING TWO EXAMPLES TYMS, encoding thymidylate synthase (target of permetrexed). Roe OD et al. Genome-wide profile of pleural mesothelioma versus parietal and visceral pleura: the emerging gene portrait of the mesothelioma phenotype. PLoS One 2009 Aug 7; 4: e G2/M transition, MMP 14 expression. Crispi S et. al. Global gene expression profiling of human pleural mesothelioma: identification of matrix metalloproteinase 14 (MMP-14) as potential tumor target. PLoS One 2009 Sep 15; 4, e ROLE OF PATHOLOGIST IN TREATMENT OPTIONS Staging on stripping specimen. Superficial invasion may be resectable by pleurectomy or pneumonectomy (controversial). Invasion of soft tissue of chest wall not resectable. Staging of biopsies of mediastinal nodes and peritoneum. Mesenchymal histology not resectable (poorer prognosis and dense tumor stuck to chest wall). STAGING OF DIFFUSE MALIGNANT MESOTHELIOMA Stage 0 Stage I Stage II Stage III Stage IV In situ (epipleural). Tumor confined to ipsilateral pleura and lung or to peritoneal cavity. Tumor involving chest wall, mediastinum, pericardium or contralateral pleura. Tumor involving both thorax and abdomen or lymph nodes outside the chest or abdomen. Distant blood bone marrow metastasis. 21

22 DMM : CARTOON FOR STAGING DMM : STAGING INVASION DMM Septal spread. 22

23 MESOTHELIOMA: UNUSUAL CLINICAL PRESENTATIONS No tumor visible at surgery. Metastasis in nodes or bones. Miliary nodules on x-ray. Mediastinal mass. Intrapulmonary mass. Coexistent carcinoma. BETTER PROGNOSIS FOR DIFFUSE MALIGNANT MESOTHELIOMA WRONG DIAGNOSIS. EPIPLEURAL (STAGE 1). EPITHELIOID (VS. MESENCHYMAL). MYXOPAPILLARY (?). Pleural hyaline plaque 23

24 ASB ESTOS - DEFINITION Webster s : A grayish or greenish variety of amphibole, occurring in long delicate fibers or in fibrous masses. Commercial : Family of fibrous minerals that are fire and heat resistant and relatively insoluable in strong acid and alkali. Chemical : Silica ribbon, hydoxyl groups, Mg and/or Ca, Fe, Na. 24

25 ASBESTOS - ANCIENT USAGE Prehistory (2500 B.C.) - Incorporated into Finnish pottery Ancient Greece (5 th c B.C.) asbestos referring to the unquenchable wick for the perpetual flame to the goddess Athene. Lithios amiantos, the undefiled rock after being thrown into the fire. Linum vivum (Herodotus), the living cloth as the funeral dress of kings for cremation. ASBESTOS - IDIOSYNCRATIC USAGE From the middle ages walking on hot coals. Charlemagne s non-combustible table cloth (ca 800 A.D). Marco Polo s cloth purified by fire (ca 1250 A.D.) Use in body armor (Rouen, ca 1490) Benjamin Franklin s purse (ca 1725). 25

26 ASBESTOS - EARLY INDUSTRY South Africa Blue material and wooly rock described in South Africa Syndication and early production. Canada Deposits identified in Quebec (Thetford), in part uncovered after forest fire Mountain replaced by open pit mine. 26

27 ASBESTOS MINING IN SOUTH AFRICA ASBESTOS PROCESSING IN SOUTH AFRICA From McCullough J. Asbestos Blues. Labour, Capital, Physicians & The State in south Africa. Indiana University Press,

28 28

29 UNPACKING ASBESTOS IN EAST GERMANY HOUSE BUILT OF ERIONITE IN CAPADOCCIA 29

30 ERIONITE Asbestiform fiber. Found in Anatolia, central Turkey. Caves and houses made from the rock. High incidence of diffuse malignant mesothelioma. ASBESTOS MINE IN QUEBEC 30

31 31

32 FIVE WAVES OF ASBESTOS DISEASE (first three from Selikoff) First wave Miners and millers. Second wave Tradesmen. Third wave Bystanders to asbestos in place. Fourth wave Spousal exposure. Fifth wave Occult exposure. Ref: Mark EJ, Kradin RL. Pathological recognition of diffuse malignant mesothelioma of the pleura: the significance of the historical perspective as regards this signal tumor. Sem Diag Pathol 2006; 23: FIBER BURDEN ASSAY 1. Various techniques, including usually dissolution of lung tissue. 2. Sampling issues, including lung parecnhyma, tumor, pleura. 3. Light microscopy, phase contrast microscopy, transmission electron microscopy. 4. Varying counting techniques, using grids or sediment. 5. Different clearance rates (half life) of chrysotile (weeks to months) compared to amosite and crocidolite (months to years). TAKE HOME MESSAGE Diffuse malignant mesotheliomas are increasing on a worldwide basis. The incidence parallels the historical use of asbestos. The diagnosis can be evident on routine staining. The diagnosis should not be rushed, because little is gained and much can be lost by a premature diagnosis. Cytologic features of epithelioid forms of DMM tend to be relatively bland at outset compared to metastatic carcinoma in the pleura. Multiplicity of patterns is in keeping with DMM. 32

33 A few recent articles as general references. Hammar S et al. Neoplasms ofd the Pleura, Chapter 43, in Tomashefski JF Jr et al, editors. Dail and Hammar s Pulmonary Pathology, Springer, third edition An encyclopedic work. Ordonez NG. What are the current best immunohistochemical markers for the diagnosis of epithelioid mesothelioma? A review and update. Hum Pathol 2007; 38: Mark EJ, Kradin RL: Pathological recognition of diffuse malignant mesothelioma of the pleura: the significance of the historical perspective as regards this signal tumor. Sem Diagn Pathol 2006; 23: Kradin RL, Mark EJ: Distinguishing benign mesothelial hyperplasia from neoplasia: a practical approach. Sem Diagn Pathol 2006; 23:4-14. A few recent reviews including epidemiology. Robinson BWS et al. Malignant mesothelioma. Lancet 2005; 366: Robinson BWS et al. Advances in malignant mesothelioma. New Engl J Med : Peto J et al. Continuing increase in mesothelioma mortality in Britain. Lancet 1995; 345: Hillerdal G. Mesothelioma: cases associated with nonoccupational and low dose exposure. Environ Med 1999; 56: Leigh J et al. Malignant mesothelioma in Australia, Amer J Indust Med 2002; 41: Murayama T et al. Estimation of future mortality from pleural mesothelioma in Japan based on an age-cohort model. Amer J Indust Med; 2006: 49: 1-7. Selected Comprehensive References for Mesotheliomas and Asbestos Diseases-1 Tumours of the Lung, Pleura, Thymus and Heart. World Health Organization Classification of Tumours. Travis WD et al, eds, IARC Press, Lyon, Cagle PT et. al. Color Atlas and Text of Pulmonary Pathology.. Lippincott Williams & Wilkins, Philadelphia, Second Edition, O Bryne K and Rusch V. Malignant Pleural Mesothelioma. Oxford University Press,

34 Selected Comprehensive References for Mesotheliomas and Asbestos Diseases-2 Pass HI et. Malignant Mesothelioma. Advances in Pathogenesis, Diagnosis and Translational Therapies. Springer, London, Galateau-Salle F. Pathology of Malignant Mesothelioma. Springer, London, Dodson RF and Hammar SP. Asbestos. Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis, Boca Raton, Florida DISCLOSURE I have served as an expert in litigation in cases where patients believe that they have been injured by exposure to asbestos. THE END 34

Update on Mesothelioma

Update on Mesothelioma November 8, 2012 Update on Mesothelioma Intro incidence and nomenclature Update on Classification Diagnostic specimens Morphologic features Epithelioid Histology Biphasic Histology Immunohistochemical

More information

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY Sisko Anttila, MD, PhD Jorvi Hospital Laboratory of Pathology Helsinki University Hospital Espoo, Finland 2nd Nordic Conference on Applied

More information

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY MALIGNANT MESOTHELIOMA CLASSIFICATION MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY Sisko Anttila, MD, PhD Jorvi Hospital Laboratory of Pathology Helsinki University Hospital Espoo,

More information

The develpemental origin of mesothelium

The develpemental origin of mesothelium Mesothelioma Tallinn 14.12.06 Henrik Wolff Finnish Institute of Occupational Health The develpemental origin of mesothelium Mesodermal cavities (pleura, peritoneum and pericardium ) are lined with mesenchymal

More information

Diagnosis of Mesothelioma Pitfalls and Practical Information

Diagnosis of Mesothelioma Pitfalls and Practical Information Diagnosis of Mesothelioma Pitfalls and Practical Information Mary Beth Beasley, M.D. Mt Sinai Medical Ctr Dept of Pathology One Gustave L Levy Place New York, NY 10029 (212) 241-5307 mbbeasleymd@yahoo.com

More information

PATHOLOGY OF THE PLEURA: Mesothelioma and mimickers Necessity of Immunohistochemistry. M. Praet

PATHOLOGY OF THE PLEURA: Mesothelioma and mimickers Necessity of Immunohistochemistry. M. Praet PATHOLOGY OF THE PLEURA: Mesothelioma and mimickers Necessity of Immunohistochemistry M. Praet Pathology of the Pleura Normal serosa: visceral and parietal layers Inflammation Neoplasia: Primary: mesothelioma

More information

Notice of Faculty Disclosure

Notice of Faculty Disclosure The Diagnosis of Malignant Mesothelioma Andrew Churg, MD Department of Pathology University of British Columbia Vancouver, BC, Canada achurg@mail.ubc.ca Notice of Faculty Disclosure In accordance with

More information

Case of the. Month October, 2012

Case of the. Month October, 2012 Case of the Month October, 2012 Case The patient is a 47-year-old male with a 3-week history of abdominal pain. A CT scan of the abdomen revealed a suggestion of wall thickening at the tip of the appendix

More information

Recommendations for the Reporting of Pleural Mesothelioma

Recommendations for the Reporting of Pleural Mesothelioma Recommendations for the Reporting of Pleural Mesothelioma Association of Directors of Anatomic and Surgical Pathology * DOI: 10.1309/6A30YQHBMTHEJTEM It has been evident for decades that pathology reports

More information

3-F. Pathology of Mesothelioma

3-F. Pathology of Mesothelioma 3-F. Pathology of Mesothelioma Kouki Inai Professor of Department of Pathology, Graduate School of Biomedical Science, Hiroshima University Introduction Mesothelioma is a peculiar type of malignancy, which

More information

Diagnostic Challenge. Department of Pathology,

Diagnostic Challenge. Department of Pathology, Cytology of Pleural Fluid as a Diagnostic Challenge Paavo Pääkkö,, MD, PhD Chief Physician and Head of the Department Department of Pathology, Oulu University Hospital,, Finland Oulu University Hospital

More information

بسم هللا الرحمن الرحيم

بسم هللا الرحمن الرحيم بسم هللا الرحمن الرحيم Updates in Mesothelioma By Samieh Amer, MD Professor of Cardiothoracic Surgery Faculty of Medicine, Cairo University History Wagner and his colleagues (1960) 33 cases of mesothelioma

More information

Pathology of lung cancer

Pathology of lung cancer Pathology of lung cancer EASO COURSE ON LUNG CANCER AND MESOTHELIOMA DAMASCUS (SYRIA), MAY 3-4, 2007 Gérard ABADJIAN MD Pathologist Associate Professor, Saint Joseph University Pathology Dept. Hôtel-Dieu

More information

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours Pleura Visceral pleura covers lungs and extends into fissures Parietal pleura limits mediastinum and covers dome of diaphragm and inner aspect of chest wall. Two layers between them (pleural cavity) contains

More information

YOUR LUNG CANCER PATHOLOGY REPORT

YOUR LUNG CANCER PATHOLOGY REPORT UNDERSTANDING YOUR LUNG CANCER PATHOLOGY REPORT 1-800-298-2436 LungCancerAlliance.org A GUIDE FOR THE PATIENT 1 CONTENTS What is a Pathology Report?...3 The Basics...4 Sections of a Pathology Report...7

More information

P L E U R A L M E S O T H E L I O M A

P L E U R A L M E S O T H E L I O M A For media outside the US, UK and Canada only P L E U R A L M E S O T H E L I O M A 1. Overview 2. What is pleural mesothelioma? 3. How common is pleural mesothelioma? 4. What are the risk factors for pleural

More information

INFLAMMATORY PLEURAL EFFUSION

INFLAMMATORY PLEURAL EFFUSION PLEURA- LESIONS LESIONS OF PLEURA Primary Intra pleural bacterial infections Neoplasm (mesothelioma) Secondary A complication of some underlying disease PLEURAL EFFUSION Common manifestation of both primary

More information

Académie internationale de Pathologie - Division arabe XX ème congrès 24-26 novembre 2008 Alger. Immunohistochemistry in malignant mesotheliomas

Académie internationale de Pathologie - Division arabe XX ème congrès 24-26 novembre 2008 Alger. Immunohistochemistry in malignant mesotheliomas Académie internationale de Pathologie - Division arabe XX ème congrès 24-26 novembre 2008 Alger Immunohistochemistry in malignant mesotheliomas Françoise Thivolet-Béjui Groupement Hospitalier Est Lyon-Bron

More information

Protocol for the Examination of Specimens From Patients With Malignant Pleural Mesothelioma

Protocol for the Examination of Specimens From Patients With Malignant Pleural Mesothelioma Protocol for the Examination of Specimens From Patients With Malignant Pleural Mesothelioma Based on AJCC/UICC TNM, 7th edition Protocol web posting date: February 1, 2011 Procedures Resection Authors

More information

Case based applications part III

Case based applications part III Case based applications part III Los Angeles Society Of Pathologists January 25, 2014 Sanja Dacic, MD, PhD University of Pittsburgh Medical Center 1 CASE 1 A 44-year-old woman with multiple lung nodules.

More information

Immunohistochemistry on cytology specimens from pleural and peritoneal fluid

Immunohistochemistry on cytology specimens from pleural and peritoneal fluid Immunohistochemistry on cytology specimens from pleural and peritoneal fluid Dr Naveena Singh Consultant Pathologist Bart health NHS Trust London United Kingdom Disclosures and Acknowledgements I have

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

Mesothelioma: Questions and Answers

Mesothelioma: Questions and Answers CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Mesothelioma: Questions

More information

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project

INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER Prospective Mesothelioma Staging Project Data Forms and Fields in CRAB Electronic Data Capture System - Reduced Set - Pivotal data elements for developing

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Defending the Mesothelioma Case:

Defending the Mesothelioma Case: Defending the Mesothelioma Case: Types, Alternative Causes, and Working Up the Case Mary Price Birk Baker & Hostetler, LLP 303 East 17 th Avenue, Suite 1100 Denver, CO 80202 (303) 764-4041 (303) 861-7805

More information

Male. Female. Death rates from lung cancer in USA

Male. Female. Death rates from lung cancer in USA Male Female Death rates from lung cancer in USA Smoking represents an interesting combination of an entrenched industry and a clearly drug-induced cancer Tobacco Use in the US, 1900-2000 5000 100 Per Capita

More information

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Changes in Breast Cancer Reports After Second Opinion Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Second Opinion in Breast Pathology Usually requested when a patient is referred

More information

Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1

Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1 Mesothelioma Introduction Mesothelioma is a type of cancer. It starts in the tissue that lines your lungs, stomach, heart, and other organs. This tissue is called mesothelium. Most people who get this

More information

Outline. Workup for metastatic breast cancer. Metastatic breast cancer

Outline. Workup for metastatic breast cancer. Metastatic breast cancer Metastatic breast cancer Immunostain Update: Diagnosis of metastatic breast carcinoma, emphasizing distinction from GYN primary 1/3 of breast cancer patients will show metastasis 1 st presentation or 20-30

More information

More than 2,500 people are diagnosed with mesothelioma in the UK each year.

More than 2,500 people are diagnosed with mesothelioma in the UK each year. This information is an extract from the booklet Understanding mesothelioma. You may find the full booklet helpful. We can send you a free copy see page 5. Contents Introduction Pleural mesothelioma Peritoneal

More information

Effusions of the Serous Cavities

Effusions of the Serous Cavities Effusions of the Serous Cavities Annika Dejmek Professor/Consultant in Cytopathology Clinical Pathology; Department of Laboratory Medicine, Malmö, Lund University 5th EFCS Tutorial Trondheim 2012 Pleura

More information

Practical Effusion Cytology

Practical Effusion Cytology Practical Effusion Cytology A Community Pathologist s Approach to Immunocytochemistry in Body Fluid Cytology Emily E. Volk, MD William Beaumont Hospital Troy, MI College of American Pathologists 2004.

More information

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012 Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro Joon H. Lee 9/17/2012 Malignant Pleural Mesothelioma (Epidemiology) Incidence: 7/mil (Japan) to 40/mil (Australia) Attributed secondary to asbestos

More information

Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium

Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium Introduction 3 cavities with the same embryologic origin the mesoderme Pleura Exudates Pleura Peritoneum Pericardium 22%

More information

Histologic Classification and Differential Diagnosis of Mesothelioma

Histologic Classification and Differential Diagnosis of Mesothelioma THE YALE JOURNAL OF BIOLOGY AND MEDICINE 54 (1981), 173-180 Histologic Classification and Differential Diagnosis of Mesothelioma DARRYL CARTER, M.D. Department of Pathology, Yale University School of Medicine,

More information

Thoracic Mesothelium. Protocol applies to malignant thoracic mesothelioma. Procedures Cytology (No Accompanying Checklist) Incisional Biopsy Resection

Thoracic Mesothelium. Protocol applies to malignant thoracic mesothelioma. Procedures Cytology (No Accompanying Checklist) Incisional Biopsy Resection Thoracic Mesothelium Protocol applies to malignant thoracic mesothelioma. Protocol revision date: January 2004 Based on AJCC/UICC TNM, 6 th edition Procedures Cytology (No Accompanying Checklist) Incisional

More information

TUMORS OF THE TESTICULAR ADNEXA and SPERMATIC CORD

TUMORS OF THE TESTICULAR ADNEXA and SPERMATIC CORD TUMORS OF THE TESTICULAR ADNEXA and SPERMATIC CORD Victor E. Reuter, MD Memorial Sloan-Kettering Cancer Center reuterv@mskcc.org 66 th Annual Pathology Seminar California Society of Pathologists Short

More information

Standards and datasets for reporting cancers. Dataset for the histological reporting of mesothelioma. April 2013

Standards and datasets for reporting cancers. Dataset for the histological reporting of mesothelioma. April 2013 Standards and datasets for reporting cancers Dataset for the histological reporting of mesothelioma April 2013 Authors Professor Andrew G Nicholson, Royal Brompton Hospital and Harefield NHS Trust Professor

More information

Protocol applies to all primary borderline and malignant epithelial tumors, and malignant mesothelial neoplasms of the peritoneum.

Protocol applies to all primary borderline and malignant epithelial tumors, and malignant mesothelial neoplasms of the peritoneum. Peritoneum Protocol applies to all primary borderline and malignant epithelial tumors, and malignant mesothelial neoplasms of the peritoneum. Protocol revision date: January 2004 No AJCC/UICC staging system

More information

The Diagnosis of Cancer in the Pathology Laboratory

The Diagnosis of Cancer in the Pathology Laboratory The Diagnosis of Cancer in the Pathology Laboratory Dr Edward Sheffield Christmas Select 74 Meeting, Queen s Hotel Cheltenham, 3 rd December 2014 Agenda Overview of the pathology of cancer How specimens

More information

A 70-year old Man with Pleural Effusion

A 70-year old Man with Pleural Effusion Mesothelioma Diagnosis: Pitfalls and Latest Updates S Klebe and DW Henderson Recommendations Indisputable malignant cells on cytomorphological criteria which demonstrate a mesothelial phenotype, which

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Understanding Pleural Mesothelioma

Understanding Pleural Mesothelioma Understanding Pleural Mesothelioma UHN Information for patients and families Read this booklet to learn about: What is pleural mesothelioma? What causes it? What are the symptoms? What tests are done to

More information

Protocol for the Examination of Specimens From Patients With Tumors of the Peritoneum

Protocol for the Examination of Specimens From Patients With Tumors of the Peritoneum Protocol for the Examination of Specimens From Patients With Tumors of the Peritoneum Protocol applies to all primary borderline and malignant epithelial tumors and malignant mesothelial neoplasms of the

More information

Influence of Fiber Type, Size, and Number in Human Disease: Conclusions from Fiber Burden Analysis

Influence of Fiber Type, Size, and Number in Human Disease: Conclusions from Fiber Burden Analysis Influence of Fiber Type, Size, and Number in Human Disease: Conclusions from Fiber Burden Analysis Andrew Churg, MD Department of Pathology University of British Columbia Vancouver, BC, Canada Techniques,

More information

Cytological Diagnosis of Malignant Pleural Mesothelioma: A Cautionary Note for Lawyers in Asbestos Litigation

Cytological Diagnosis of Malignant Pleural Mesothelioma: A Cautionary Note for Lawyers in Asbestos Litigation Cytological Diagnosis of Malignant Pleural Mesothelioma: A Cautionary Note for Lawyers in Asbestos Litigation Edward Casmere and Joshua Lee Law360 March 7, 2014 For a variety of reasons, lawyers in asbestos

More information

A. Pericardial smear. Examination of the pericardial aspirate can provide useful diagnostic information.

A. Pericardial smear. Examination of the pericardial aspirate can provide useful diagnostic information. 5. PERICARDIUM Heart is encased by the pericardium which has a visceral layer (a) covering the heart and the parietal layer (b). In normal states it is thin, transparent and the myocardium can be seen

More information

What is Mesothelioma?

What is Mesothelioma? What is Mesothelioma? Mesothelioma is a rare type of cancer that develops in the mesothelial cells found in one s body. These cells form membranous linings that surround and protect the body s organs and

More information

General Rules SEER Summary Stage 2000. Objectives. What is Staging? 5/8/2014

General Rules SEER Summary Stage 2000. Objectives. What is Staging? 5/8/2014 General Rules SEER Summary Stage 2000 Linda Mulvihill Public Health Advisor NCRA Annual Meeting May 2014 National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention

More information

ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3

ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3 ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3 HOW TO CITE THIS ARTICLE: Gorantla Sambasivarao, Namballa Usharani,

More information

A Cytokeratin- and Calretinin-negative Staining Sarcomatoid Malignant Mesothelioma

A Cytokeratin- and Calretinin-negative Staining Sarcomatoid Malignant Mesothelioma A Cytokeratin- and Calretinin-negative Staining Sarcomatoid Malignant Mesothelioma MICHAEL G. HURTUK and MICHELE CARBONE Cardinal Bernadin Cancer Center, Cancer Immunology Program, Department of Pathology,

More information

Plueral Malignancy: Radiologic-pathologic

Plueral Malignancy: Radiologic-pathologic Plueral Malignancy: Radiologic-pathologic Correlation Ritu R. Gill, MD Pleural Malignancies: Radiologic-Pathologic Correlation Ritu R Gill MD Brigham and Women s Hospital Boston, Massachusetts Pleural

More information

20 Diagnostic Cytopathology, Vol 36, No 1 ' 2007 WILEY-LISS, INC.

20 Diagnostic Cytopathology, Vol 36, No 1 ' 2007 WILEY-LISS, INC. Utility of WT-1, p63, MOC31, Mesothelin, and Cytokeratin (K903 and CK5/6) Immunostains in Differentiating Adenocarcinoma, Squamous Cell Carcinoma, and Malignant Mesothelioma in Effusions Robert T. Pu,

More information

Malignant mesothelioma of the pleura: relation

Malignant mesothelioma of the pleura: relation Thorax 1982;37:810-815 Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour MR LAW, MARGARET E HODSON, BE HEARD From the Cardiothoracic Institute and Brompton

More information

HKCPath Anatomical Pathology Peer Review and Scores : PDF version for download

HKCPath Anatomical Pathology Peer Review and Scores : PDF version for download AP2003R1 http://hkcpath.org. Correspondence: pkhui@ha.org.hk 1of 10 07/08/2003 HKCPath Anatomical Pathology Peer Review and Scores : PDF version for download AP141 Bone Marrow: Metastatic Carcinoma from

More information

Effusions: Mesothelioma and Metastatic Cancers

Effusions: Mesothelioma and Metastatic Cancers Effusions: Mesothelioma and Metastatic Cancers Malignant Mesothelioma Incidence: 2,500 cases/year ~60-80% pts with pleural MM relationship with asbestos exposure Other risk factors: radiation, other carcinogens,

More information

HEALTH CARE FOR EXPOSURE TO ASBESTOS. 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun.

HEALTH CARE FOR EXPOSURE TO ASBESTOS. 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun. HEALTH CARE FOR PATIENTS WITH EXPOSURE TO ASBESTOS 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun.ca HEALTH CARE FOR PATIENTS WITH EXPOSURE

More information

Uses and Abuses of Pathology in Asbestos-exposed Populations

Uses and Abuses of Pathology in Asbestos-exposed Populations Uses and Abuses of Pathology in Asbestos-exposed Populations Jerrold L. Abraham, MD Department of Pathology State University of New York Upstate Medical University Syracuse, NY, 13210 USA The term: Asbestosis,

More information

Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Effusion = Confusion

Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Effusion = Confusion Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Effusion = Confusion Syed Z. Ali, M.D. Professor of Pathology and Radiology The Johns Hopkins Hospital Baltimore, Maryland Diagnostic

More information

Neoplasms of the LUNG and PLEURA

Neoplasms of the LUNG and PLEURA Neoplasms of the LUNG and PLEURA 2015-2016 FCDS Educational Webcast Series Steven Peace, BS, CTR September 19, 2015 2015 Focus o Anatomy o SSS 2000 o MPH Rules o AJCC TNM 1 Case 1 Case Vignette HISTORY:

More information

Mesothelioma. 1. Introduction. 1.1 General Information and Aetiology

Mesothelioma. 1. Introduction. 1.1 General Information and Aetiology Mesothelioma 1. Introduction 1.1 General Information and Aetiology Mesotheliomas are tumours that arise from the mesothelial cells of the pleura, peritoneum, pericardium or tunica vaginalis [1]. Most are

More information

Francine Lortie-Monette, MD, MSc, CSPQ, MBA Department of Epidemiology and Biostatistics University of Western Ontario 2003

Francine Lortie-Monette, MD, MSc, CSPQ, MBA Department of Epidemiology and Biostatistics University of Western Ontario 2003 ASBESTOS Francine Lortie-Monette, MD, MSc, CSPQ, MBA Department of Epidemiology and Biostatistics University of Western Ontario 2003 Asbestosis Asbestosis is a model for other dust diseases as well as

More information

Malignant Mesothelioma Recent Advances

Malignant Mesothelioma Recent Advances Malignant Mesothelioma Recent Advances Dr AS Paul 04 Aug 06 DM Seminar Malignant mesothelioma A tumour of serosal surfaces Pleura, peritoneum Increasing incidence worldwide Association with asbestos exposure

More information

Survey of Mesothelioma Associated with Asbestos Exposure in Japan

Survey of Mesothelioma Associated with Asbestos Exposure in Japan The research and development and the dissemination projects related to the 13 fields of occupational injuries and illnesses Survey of Mesothelioma Associated with Asbestos Exposure in Japan Clinical characteristics

More information

BY THE NUMBERS: THE FUTURE OF MESOTHELIOMA IN AMERICA

BY THE NUMBERS: THE FUTURE OF MESOTHELIOMA IN AMERICA BY THE NUMBERS: THE FUTURE OF MESOTHELIOMA IN AMERICA 1 CUTTING-EDGE ISSUES IN ASBESTOS LITIGATION CONFERENCE Scott Masterson Lewis, Brisbois, Bisgaard & Smith, LLP 1180 Peachtree Street, NE, Suite 2900

More information

Thoracic Cavity. Photo: This normal canine lung collapsed when the thorax was opened and the negative pressure was lost in the thorax.

Thoracic Cavity. Photo: This normal canine lung collapsed when the thorax was opened and the negative pressure was lost in the thorax. Thoracic Cavity There are significant anatomical differences in the mediastinum of domestic animals. For instance, bovines, like humans, have well-developed mediastinal separation between the left and

More information

Ovarian tumors Ancillary methods

Ovarian tumors Ancillary methods Ovarian tumors Ancillary methods Ovarian tumor course Oslo, 24-25/11/14 Prof. Ben Davidson, MD PhD Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway Division of

More information

Sternotomy and removal of the tumor

Sternotomy and removal of the tumor Sternotomy and removal of the tumor All thymomas originate from epithelial thymic cells 4% of them consist of a pure population of epithelial cells Most have mixed populations of lymphoid cells to a

More information

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200 GUIDE TO ASBESTOS LUNG CANCER What Is Asbestos Lung Cancer? Like tobacco smoking, exposure to asbestos can result in the development of lung cancer. Similarly, the risk of developing asbestos induced lung

More information

Disclosures. Learning Objectives. Effusion = Confusion. Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell!

Disclosures. Learning Objectives. Effusion = Confusion. Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Disclosures Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! No Relevant Financial Relationships with Commercial Interests Syed Z. Ali, M.D. Syed Z. Ali, M.D. Associate Professor of

More information

Introduction: Tumor Swelling / new growth / mass. Two types of growth disorders: Non-Neoplastic. Secondary / adaptation due to other cause.

Introduction: Tumor Swelling / new growth / mass. Two types of growth disorders: Non-Neoplastic. Secondary / adaptation due to other cause. Disorders of Growth Introduction: Tumor Swelling / new growth / mass Two types of growth disorders: Non-Neoplastic Secondary / adaptation due to other cause. Neoplastic. Primary growth abnormality. Non-Neoplastic

More information

PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT

PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT Dott. Francesco Pontieri (*) U.O. di Anatomia Patologica P.O. di Rossano (CS) Dott. Gian Franco Zannoni Anatomia Patologica Facoltà di Medicina e Chirurgia

More information

Lung Cancer. This reference summary will help you better understand lung cancer and the treatment options that are available.

Lung Cancer. This reference summary will help you better understand lung cancer and the treatment options that are available. Lung Cancer Introduction Lung cancer is the number one cancer killer of men and women. Over 165,000 people die of lung cancer every year in the United States. Most cases of lung cancer are related to cigarette

More information

MALIGNANT MESOTHELIOMA: A TYPICAL PRESENTATION IN AN ATYPICAL PATIENT

MALIGNANT MESOTHELIOMA: A TYPICAL PRESENTATION IN AN ATYPICAL PATIENT MALIGNANT MESOTHELIOMA: A TYPICAL PRESENTATION IN AN ATYPICAL PATIENT Written by: Karyn Varley MS, SCT(ASCP) The donating laboratory would like to remain anonymous. PATIENT HISTORY 28 year old female Lived

More information

General Information About Non-Small Cell Lung Cancer

General Information About Non-Small Cell Lung Cancer General Information About Non-Small Cell Lung Cancer Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung. The lungs are a pair of cone-shaped breathing

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1557/14

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1557/14 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1557/14 BEFORE: M. Crystal: Vice-Chair HEARING: August 20, 2014 at Toronto Written DATE OF DECISION: December 4, 2014 NEUTRAL CITATION: 2014

More information

The evolving pathology of solitary fibrous tumours. Luciane Dreher Irion MREH / CMFT / NSOPS

The evolving pathology of solitary fibrous tumours. Luciane Dreher Irion MREH / CMFT / NSOPS The evolving pathology of solitary fibrous tumours Luciane Dreher Irion MREH / CMFT / NSOPS Historical review Haemangiopericytoma (HPC) first described primarily as a soft tissue vascular tumour of pericytic

More information

Today s Topics. Tumors of the Peritoneum in Women

Today s Topics. Tumors of the Peritoneum in Women Today s Topics Tumors of the Peritoneum in Women Charles Zaloudek, M.D. Department of Pathology 505 Parnassus Ave., M563 University of California, San Francisco San Francisco, CA USA charles.zaloudek@ucsf.edu

More information

Cytopathology Case Presentation #8

Cytopathology Case Presentation #8 Cytopathology Case Presentation #8 Emily E. Volk, MD William Beaumont Hospital, Troy, MI Jonathan H. Hughes, MD Laboratory Medicine Consultants, Las Vegas, Nevada Clinical History 44 year old woman presents

More information

ISOLATED PANCREATIC METASTASIS OF A MALIGNANT PLEURAL MESOTHELIOMA

ISOLATED PANCREATIC METASTASIS OF A MALIGNANT PLEURAL MESOTHELIOMA ISOLATED PANCREATIC METASTASIS OF A MALIGNANT PLEURAL MESOTHELIOMA Yi-Ting Lin, 1 Bing-Shiun Wu, 2 Sheau-Fang Yang, 3 and Huang-Chi Chen 4 Departments of 1 Family Medicine, 2 Internal Medicine, and 3 Pathology,

More information

British Thoracic Society Standards of Care Committee

British Thoracic Society Standards of Care Committee 250 Thorax 2001;56:250 265 BTS statement Statement on malignant mesothelioma in the United Kingdom British Thoracic Society Standards of Care Committee Correspondence to: Dr J Wiggins, Wexham Park Hospital,

More information

J of Evidence Based Med & Hlthcare, pissn- 2349-2562, eissn- 2349-2570/ Vol. 2/Issue 33/Aug. 17, 2015 Page 5063

J of Evidence Based Med & Hlthcare, pissn- 2349-2562, eissn- 2349-2570/ Vol. 2/Issue 33/Aug. 17, 2015 Page 5063 PERITONEAL MALIGNANT MESOTHELIOMA: A RARE S. R. Dhamotharan 1, S. Shanthi Nirmala 2, F. Celine Foustina Mary 3, M. Arul Raj Kumar 4, R. Vinothprabhu 5 HOW TO CITE THIS ARTICLE: S. R. Dhamotharan, S. Shanthi

More information

Role of immunohistochemistry

Role of immunohistochemistry Tumors of serous membranes of difficult diagnosis: Dr. Hector Battifora Role of immunohistochemistry Abstract: The most common differential diagnosis of tumors involving serosal surfaces is adenocarcinoma

More information

Silent Time-Bomb, Mesothelioma

Silent Time-Bomb, Mesothelioma Silent Time-Bomb, Mesothelioma ーClinical Pathology Shotaro Maeda Tama-Nagayama Hospita,lNippon Medical School JAPAN Mesothelioma 1 General remarks 2 Pathology 3 Cytology 4 6 cases of the mesothelioma diagnosed

More information

Pleural Mesothelioma: An Institutional Experience of 66 Cases

Pleural Mesothelioma: An Institutional Experience of 66 Cases The Korean Journal of Pathology 2014; 48: 91-99 ORIGINAL ARTICLE Pleural Mesothelioma: An Institutional Experience of 66 Cases Soomin Ahn In Ho Choi Joungho Han Jhingook Kim 1 Myung-Ju Ahn 2 Departments

More information

Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma

Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma I d like to welcome everyone, thanks for coming out to our lunch with experts. The faculty today are great people in the thoracic

More information

Treatment of mesothelioma in Bloemfontein, South Africa

Treatment of mesothelioma in Bloemfontein, South Africa European Journal of Cardio-thoracic Surgery 24 (2003) 434 440 www.elsevier.com/locate/ejcts Treatment of mesothelioma in Bloemfontein, South Africa W.J. de Vries*, M.A. Long Cardiothoracic Department,

More information

Diagnostic Pitfalls In Thoracic Tumors

Diagnostic Pitfalls In Thoracic Tumors 1376 Diagnostic Pitfalls In Thoracic Tumors Neda Kalhor, MD Cesar A. Moran, MD, FASCP WEEKEND OF PATHOLOGY AMERICAN SOCIETY FOR CLINICAL PATHOLOGY 33 W Monroe Ste 1600 Chicago, IL 60603 Program Content

More information

Case Report Predominantly Fibrous Malignant Mesothelioma in a Cat

Case Report Predominantly Fibrous Malignant Mesothelioma in a Cat SAGE-Hindawi Access to Research Volume 2010, Article ID 396794, 4 pages doi:10.4061/2010/396794 Case Report Predominantly Fibrous Malignant Mesothelioma in a Cat Alexander Th. A. Weiss, Afonso B. da Costa,

More information

MESOTHELIOMA. Not Just a Late Night Commercial. Graciela Hoal, RN, MSN, ACNP-BC

MESOTHELIOMA. Not Just a Late Night Commercial. Graciela Hoal, RN, MSN, ACNP-BC MESOTHELIOMA Not Just a Late Night Commercial Graciela Hoal, RN, MSN, ACNP-BC Saturday Session Thoracic Surgery Nurse Practitioner Greater Los Angeles Veteran Affairs Objectives Course Objectives: Discuss

More information

Sir William Osler: Listen to the patient; the patient tells you everything.

Sir William Osler: Listen to the patient; the patient tells you everything. Sir William Osler: Listen to the patient; the patient tells you everything. Jean-Martin Charcot: The patient is a liar. Epidemiology of Mesothelioma Jeffrey H. Mandel, MD, MPH Division of Environmental

More information

Treatment Guide Lung Cancer Management

Treatment Guide Lung Cancer Management Treatment Guide Lung Cancer Management The Chest Cancer Center at Cleveland Clinic, which includes specialists from the Respiratory Institute, Taussig Cancer Institute and Miller Family Heart & Vascular

More information

Pleural and Chest Wall Tumors

Pleural and Chest Wall Tumors Pleural and Chest Wall Tumors Ritu Gill, MD, MPH Dr. Ritu R. Gill Department t of Radiology Brigham and Women s Hospital Harvard Medical School CLASSIFICATION OF CHEST WALL TUMORS Primary neoplasm of chest

More information

Case Report A Cause of Bilateral Chylothorax: A Case of Mesothelioma without Pleural Involvement during Initial Diagnosis

Case Report A Cause of Bilateral Chylothorax: A Case of Mesothelioma without Pleural Involvement during Initial Diagnosis Case Reports in Pulmonology Volume 2015, Article ID 962504, 4 pages http://dx.doi.org/10.1155/2015/962504 Case Report A Cause of Bilateral Chylothorax: A Case of Mesothelioma without Pleural Involvement

More information

ASBESTOS DISEASES. Dr Alastair Robertson

ASBESTOS DISEASES. Dr Alastair Robertson ASBESTOS DISEASES Dr Alastair Robertson Occupational Health Department University Hospital Birmingham Birmingham B29 6JF 01216278285 Alastair.robertson@uhb.nhs.uk Occupational Lung Disease Unit Birmingham

More information

Immunohistochemical differentiation of metastatic tumours

Immunohistochemical differentiation of metastatic tumours Immunohistochemical differentiation of metastatic tumours Dr Abi Wheal ST1. TERA 3/2/14 Key points from a review article written by Daisuke Nonaka Intro Metastatic disease is the initial presentation in

More information

Lung Carcinomas New 2015 WHO Classification. Spasenija Savic Pathology

Lung Carcinomas New 2015 WHO Classification. Spasenija Savic Pathology Lung Carcinomas New 2015 WHO Classification Spasenija Savic Pathology ***EXPECTED SPRING 2015*** This authoritative, concise reference book provides an international standard for oncologists and pathologists

More information