Malignant mesothelioma. Cytopathology of 75 cases seen in a new Jersey community hospital
Triol, J.H.; Conston, A.S.; Chandler, S.V.
Acta Cytologica 28(1): 37-45
1984
ISSN/ISBN: 0001-5547 PMID: 6198832 Document Number: 221661
Seventy-five cases 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 three major histologic varieties of mesothelioma (epithelioid, fibrous and mixed, or biphasic), the epithelioid and biphasic types were associated with four cytomorphologic features useful in the diagnostic evaluation: (1) the presence of abnormal cells, apparently mesothelial, (2) nuclei with subtle malignant features, (3) the presence of cells showing transitional forms from normal to abnormal in the same sample and (4) the presence of large tissue fragments. The fibrous mesotheliomas presented cytologically as sarcomatous neoplasms. Three histochemical reactions were found to be 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.