Clinical and pathological information on 232 patients diagnosed with epithelioid diffuse malignant pleural mesothelioma between 1989 and 2009 at Memorial Sloan-Kettering Cancer Center was collected through the Thoracic Surgery mesothelioma database and the Department of Pathology data file. Institutional Review Board approval was obtained for this study. Clinical variables recorded in the prospectively maintained database included age, gender, laterality, TNM stage, and surgical procedure. TNM staging was based on the reported imaging findings, the surgeon’s intraoperative findings, and the pathologic evaluation of the resected specimens using the sixth edition of the American Joint Commission on Cancer Staging Manual.18 All patients were followed until date of death or last follow-up.
Pathologic diagnosis was based on standard histologic, histochemical, and immunohistochemical criteria.1 ,19 (link),20 As a positive marker of immunohistochemistry for malignant pleural mesothelioma, standard immunohistochemical markers included calretinin, WT-1, cytokeratin 5/6, and D2-40. As negative markers for malignant pleural mesothelioma, we used carcinoembryonic antigen, CD15, B72.3, BerEP4, and thyroid transcription factor-1. In cases before positive mesothelial markers were available, negative markers were used for making the diagnosis of malignant pleural mesothelioma. In order to confirm original diagnosis, for specimens where tumor blocks were available, we performed immunohistochemistry for calretinin and WT-1. Only one case was negative for both markers; however, this particular patient’s clinical and radiological findings were characteristic of diffuse malignant pleural mesothelioma. The pathological diagnosis was correlated with the gross distribution of tumor and the absence of an intrapulmonary mass lesion on radiologic imaging.
Pathologic diagnosis was based on standard histologic, histochemical, and immunohistochemical criteria.1 ,19 (link),20 As a positive marker of immunohistochemistry for malignant pleural mesothelioma, standard immunohistochemical markers included calretinin, WT-1, cytokeratin 5/6, and D2-40. As negative markers for malignant pleural mesothelioma, we used carcinoembryonic antigen, CD15, B72.3, BerEP4, and thyroid transcription factor-1. In cases before positive mesothelial markers were available, negative markers were used for making the diagnosis of malignant pleural mesothelioma. In order to confirm original diagnosis, for specimens where tumor blocks were available, we performed immunohistochemistry for calretinin and WT-1. Only one case was negative for both markers; however, this particular patient’s clinical and radiological findings were characteristic of diffuse malignant pleural mesothelioma. The pathological diagnosis was correlated with the gross distribution of tumor and the absence of an intrapulmonary mass lesion on radiologic imaging.
