The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: A histologic and immunohistochemical analysis of 31 cases including p53 immunostaining

William E. Mangano, Philip T. Cagle, Andrew Churg, Robin T. Vollmer, Victor L. Roggli

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

We studied 31 patients with fibrotic pleural lesions and classified them as desmoplastic malignant mesothelioma (DMM) or fibrous pleurisy (FP) using predetermined histologic criteria, including a paucicellular fibrotic pleural lesion with a storiform pattern or the 'patternless pattern' of Stout, plus 1 or more of the following: invasion of chest wall or lung, bland necrosis, frankly sarcomatoid areas, and distant metastases. Staining for p53 was performed in 22 cases. Follow-up was obtained on all cases and compared with the histologic diagnoses. For 24 cases, the consensus diagnosis was DMM; 19 of these displayed frankly sarcomatoid areas, 16 showed invasion, and 8, bland necrosis. Of the 24, 23 patients died of disease and 1 was alive with disease. The remaining 7 cases were classified as FP, and all were alive without disease. The concordance among 3 pathologists using the criteria was excellent. Staining for p53 was more common in DMM than in FP, but the difference was not statistically significant. The concordance in interpreting the p53 stains by the same 3 pathologists was moderate. The distinction between DMM and FP in a predominantly fibrotic pleural lesion can be made in most cases with adequate sampling and the use of specific criteria.

Original languageEnglish (US)
Pages (from-to)191-199
Number of pages9
JournalAmerican Journal of Clinical Pathology
Volume110
Issue number2
DOIs
StatePublished - Jan 1 1998

Keywords

  • Desmoplastic
  • Fibrous pleurisy
  • Mesothelioma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: A histologic and immunohistochemical analysis of 31 cases including p53 immunostaining'. Together they form a unique fingerprint.

Cite this