Pathology of malignant mesothelioma

Abstract

The diagnosis of malignant mesothelioma has long been a challenge for the pulmonary pathologist but with increasing sophistication of both surgical and laboratory techniques together with advances in imaging it has become relatively easier to give a definitive opinion provided adequate diagnostic material is available. Additional information, such as subtyping, gives valuable information to aid treatment decisions and predict prognosis. Distinction of some complex proliferative lesions from mesothelioma and the characterization of primary and metastatic pleural malignancy have also been aided by new special staining techniques. It is no longer acceptable for pathologists to simply make a diagnosis of pleural malignancy without further comment on tumor type and histogenesis. There are still many pitfalls in this difficult diagnostic area and the development of multidisciplinary specialist cancer teams who review clinical, pathological, and radiological findings together are proving invaluable in consolidating a secure diagnosis and producing an appropriate treatment plan in consultation with the patient [1].