Pathological and molecular biological approaches to early mesothelioma |
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Authors: | Tohru Tsujimura Ikuko Torii Ayuko Sato Misa Song Kazuya Fukuoka Seiki Hasegawa Takashi Nakano |
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Institution: | (1) Department of Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya Hyogo, 663-8501, Japan;(2) Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya Hyogo, 663-8501, Japan;(3) Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya Hyogo, 663-8501, Japan |
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Abstract: | Malignant mesothelioma is an asbestos-related malignancy that arises primarily from mesothelial cells on the serosal surfaces
of the pleural, peritoneal, and pericardial cavities. Malignant pleural mesothelioma (MPM) is most common, and its incidence
is dramatically increasing worldwide as a result of widespread use of asbestos. Morphological discrimination between MPM and
reactive mesothelial hyperplasia is difficult, and the most reliable pathological criterion for malignancy is mesothelial
proliferation invading deeply into subpleural adipose tissues. To establish radical cure of MPM, it is crucial to find early-stage
MPM of epithelial type, in which mesothelial proliferation is localized on the serosal surface of parietal pleura or limited
within the submesothelial fibrous tissues of parietal pleura. The initial clinical presentation for patients with MPM is frequently
dyspnea and/or chest pain due to large pleural effusion, and cytological analysis of pleural effusions is valuable to find
patients with early-stage MPM of epithelial type. Recently, cytological features of MPM in pleural effusion, molecular markers
for MPM, and genetic alternations of MPM have been reported. In this review, we discuss major issues on pathological and molecular
biological approaches for diagnosis of early-stage MPM of epithelial type. |
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