Diagnostic value of biopsy sampling in predicting histology in patients with diffuse malignant pleural mesothelioma

Cancer
Lucian R ChirieacRaphael Bueno

Abstract

The classification of diffuse malignant mesothelioma into epithelioid, biphasic, and sarcomatoid types is based on histologic patterns. The diagnosis is made on biopsies, and because of intratumoral heterogeneity, they may not be representative of the entire tumor. The number and volume of biopsies needed to reach diagnostic accuracy in diffuse malignant mesothelioma and their prognostic value remain unclear. This study examined 759 consecutive patients with pleural diffuse malignant mesothelioma treated by pleurectomy/decortication or extrapleural pneumonectomy for the presence of epithelioid and/or sarcomatoid histology and classified both the presurgery biopsies (core-needle or thoracoscopic) and surgical resection specimens. The number and volume of biopsies were correlated with pre- and postsurgery histologies and overall survival. Diffuse malignant mesothelioma was classified as epithelioid (76%), biphasic (18%), sarcomatoid (5%), or indeterminate (1%) in biopsies and as epithelioid (64%), biphasic (32%), and sarcomatoid (4%) in surgical resection specimens (overall concordance, 80.6%). The positive likelihood ratios were 2.4, 13.6, and 90.1 for biopsies with epithelioid, biphasic, and sarcomatoid histologies, respectivel...Continue Reading

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Citations

Jul 3, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Rajesh ThomasY C Gary Lee
Jan 8, 2021·Virchows Archiv : an International Journal of Pathology·Lynnette Fernandez-CuestaMatthieu Foll
Oct 6, 2020·Thoracic Surgery Clinics·Yin P Hung, Lucian R Chirieac
May 17, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Wenwen SunLin Fan

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