Localized Splenic Malignant Mesothelioma
Appl Radiol. 2011;40(09):22-24.
Little has been reported about localized malignant mesothelioma. In a series of 23 patients with localized malignant mesothelioma described by Allen TC, et al., 21 (91%) were pleural based, while 2 (9%) were peritoneal.[3] The age at mean presentation was 63 years with a male:female ratio of 2:1.
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Localized malignant mesothelioma is histologically, immunohistochemically, and ultrastructurally identical to diffuse malignant mesothelioma. Epithelial-types predominate with the remainder being sarcomatous or mixed. Light microscopy of malignant epithelioid mesothelioma is characterized by sheets of polygonal cells with abundant eosinophilic cytoplasm, round nuclei, and prominent nucleoli.[2] All mesotheliomas stain positive for keratin. The best immunohistochemical markers for differentiating epithelial malignant mesotheliomas from papillary serous carcinomas are calretinin, thrombomodulin and keratin 5/6 positivity.[2] Calretinin has the highest sensitivity for malignant epitheliod mesothelioma. Negativity for adenocarcinoma markers such as CEA and TTF-1 are important discriminators.
The prognosis for localized malignant mesothelioma is favorable compared to diffuse malignant mesothelioma. Cytoreductive surgery and intraperitoneal chemotherapy are treatment options for diffuse malignant mesothelioma, whereas most cases of localized malignant mesothelioma are cured by surgical excision.
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