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  P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15586

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    P3.08-009 - Diagnostic Efficacy of Electron Microscopy to Distinguish between Pleural Mesothelioma and Lung Adenocarcinoma in Pleural Effusion Cytology (ID 2310)

    09:30 - 09:30  |  Author(s): C.E. González-Carrillo
    • Abstract
    • Slides

    Background:
    Mesothelioma is a mesodermic tumor localized in the pleura in 70-90% of the presentations. In most cases the diagnosis is made by computed tomography-guided biopsy or thoracoscopy. Characteristically mesothelioma includes papillary structures which make it difficult to distinguish from adenocarcinoma on hematoxylin and eosin stain, making this entity its main differential diagnosis. Immunohistochemical studies in biopsy specimens aids in the obtaining of a precise diagnosis. Notwithstanding it is often difficult to distinguish between both entities, in which case, electron microscopy is the gold standard as it allows to observe the abundant long thin microvilli (characteristic of the mesothelium) in tumor cells. Sometimes patients have only pleural effusion cytology which makes the diagnosis more challenging.
    
    Methods:
    Twenty-five pleural effusion cytology samples were studied to evaluate electron microscopy and its efficacy for diagnosis, as well as by immunohistochemistry for the diagnosis of either lung adenocarcinoma or mesothelioma.
    
    Results:
    Five pleural effusion samples with the histological diagnosis of mesothelioma and twenty with the histological diagnosis of adenocarcinoma, all with confirmed biopsies by immunohistochemistry. Of the five pleural effusion samples with histological diagnosis of mesothelioma, cytology in electron microscopy showed morphological characteristics of mesothelioma (long thin microvilli, dense junctions, desmosomes and tonofilaments ) in two samples (40%), and three were acellular (60%). Of the twenty pleural effusion samples with histologically confirmed diagnosis of adenocarcinoma (short microvilli, secretory vacuoles and intracytoplasmic lumens), eight were confirmed by electron microscopy (40%), eleven were acellular (55%), and one showed reactive mesothelium (5%).
    
    Conclusion:
    Pleural effusion cytology by electron microscopy showed that cells maintained their morphological features, either of mesothelioma or of lung adenocarcinoma, and can help in the diagnosis; however this is limited to the presence of cells in the pleural effusion
    
    

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