MALIGNANT MESOTHELIOMA - CYTOPATHOLOGY OF 75 CASES SEEN IN A NEW-JERSEY COMMUNITY-HOSPITAL

  • 1 January 1984
    • journal article
    • research article
    • Vol. 28  (1) , 37-45
Abstract
Cases (75) of diffuse pleural and/or peritoneal malignant mesothelioma (73 of body cavity fluids and 2 of fine needle aspirates) were studied by cytologic methods. Of the 3 major histologic varieties of mesothelioma (epithelioid, fibrous and mixed, or biphasic), the epithelioid and biphasic types were associated with 4 cytomorphologic features useful in the diagnostic evaluation: the presence of abnormal cells, apparently mesothelial; nuclei with subtle malignant features; the presence of cells showing transitional forms from normal to abnormal in the same sample; the presence of large tissue fragments. The fibrous mesotheliomas presented cytologically as sarcomatous neoplasms. Three histochemical reactions were valuable adjuncts to diagnosis in the differentiation of the primary malignancies of the serous membranes from metastatic cancers. These stains were the periodic acid-Schiff, with and without diastase digestion, the Alcian blue, with and without hyaluronidase digestion, and the Van Gieson. The histochemistry was diagnostically useful in 42% of the cases in which the cytomorphologic impression was uncertain or equivocal; it served as an added confirmatory finding in 64% of the cytologically diagnosable mesotheliomas.