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A brief overof peritoneal mesotheliomaPleural and peritoneal mes


othelioma, the difference between
Mesothelioma, and asbestosis in the difference betweenMesothelioma, a long trail of legal casesWhat is mesothelioma and what to do, if you are diagnosed with itWhat to do, if you have mesothelioma symptoms
What to do, when you accept a diagnosis of mesothelioma
Moment the word: pathologic diagnosis of pleural mesothelioma, pleural mesothelioma is a rare tumor, but its fall ill in recent years, the rate of increasing year by year the situation. The differentiation between the potential effect of multiple skin malignant mesothelioma resulting in a variety of cell morphology under light microscope and pleural metastatic adenocarcinoma, the effectiveness of mesothelial cells and other spindle cell tumors is not easy to identify, to the professional with clinical and pathological diagnosis to hard. Familiar in recent years due to pleural mesothelioma level device revolution and electron microscopy, immunohistochemical techniques applied to the diagnosis of pleural mesothelioma have a great level device revolution. A light microscope investigation of the diversity of the mesothelioma cell morphology by light microscopy of malignant mesothelioma body typing is not the same. Global Clean agencies have to diffuse malignant mesothelioma (dMM) into epithelial type, type and mixed type of neoplasia. 1, etc. adams dMM autopsy evidence of pleural epithelioid talent into the tumor type, tubular papillary type, neoplasm-like type, myxoid type, desmoid tumor-like type and mixed type. And suggested that diffuse pleural tumors, such as collagen aware of tumor cells can be provided that it is dMM. Otherwise, there should be small vacuoles within the cytoplasm and uniform light to moderate nuclear / cytoplasm ratio. 2 in the States and other evidence of tumor cell arrangement method of a tumor cell differentiation and tumor cells of different factors that account for at least 50% of the tumors were divided into 11 system types: tubular-like type, tubular papillary type, undifferentiated type, fibroblast cell type, signet ring-like cell type, myxoid type, myofibroblastic cell type, the blood cell-like body type, blood type mother cells, small cell type and mixed cell type. And that the following areas of help from the light microscopy diagnosis of this tumor: a special joint presentation of the tumor location; way to find tumor differentiation, especially when the trust should be more drawn to this production observed tumor; picture of tumor cell migration transition ; mix many different types of tumor cells exist; that critical clinical, but less common tumors such as nuclear break. 2 electron microscopy investigation of tumor cells and tumor cells bore surface of the dial has slender microvilli Punta hair samples, the increase in cytoplasmic filaments and glycogen granules tension, with double or intermittent basement membrane, tumor cells have more desmosomes of the ultrastructural features of the dMM 3. And microvilli, intermediate filaments and cytoplasm triad of new cavity called mesothelioma. The adenocarcinoma stubby microvilli, secretory granules within the cytoplasm, changes in extracellular glandular adenocarcinoma characteristic shape. 4 in countries such as analysis of the aspect ratio aware dMM uniform microvilli rate "11, and pleural metastatic adenocarcinoma rates even plush aspect ratio <5, the proposed uniform aspect ratio of microvilli and adenocarcinoma can be distinguished as dMM The once indicators. Pleural dMM and pleural metastatic adenocarcinoma uniform length of the difference between the desmosomes was not obvious, but the number of pleural dMM desmosomes varying length of more than 1.5 m, and pleural metastatic adenocarcinoma in 1 case no longer than 1.5 desmosome m. Therefore, the application ultrastructure measuring the length of the bridge particles and pleural pleural dMM diagnosis and diagnosis of metastatic adenocarcinoma to identify some specific value. 3 bodies secrete chemical investigation dMM hyaluronic acid, can be blue or colloidal iron textile dioxin. After pre-treatment with hyaluronidase positive effect. A small portion of cancer may also positive effect, but after treatment with hyaluronidase positive. Neutral mucin secreting adenocarcinoma, pAS-D textile positive. And due to containing a large number of glycogen dMM, pAS textile can be positive, but after pre-treatment with amylase positive. Therefore, chemical textile sector in dMM the diagnosis of lung adenocarcinoma and identify a specific assistance. However, water-soluble hyaluronic acid in the samples fixed, easily lost in the textile process. And 50% of lung cancer does not occur neutral mucin. Therefore, the false positive rate of textile and chemical sector, will gradually be replaced by immunohistochemistry. 4 immune bodies immune body chemical investigation of chemical investigation is dMM identify the most commonly used diagnostic method for diagnosis. But there is still no single antibody specificity of mesothelioma or adenocarcinoma is complete, the most commonly used antibody is only effective with adenocarcinoma. Mesothelioma diagnosis is established on the positive effect of the foundations. Often combined with several antibodies to decrease the false positive rate. Paper presented in recent years between the coherent antibody, or with low specificity, or sensitivity is poor, or only useful in the frozen section, it is not widely used. Immunohistochemistry used in the following areas: 4.1 of malignant epithelial mesothelioma and adenocarcinoma of the identification analysis of brown and other 5 perceived distinction between epithelial mesothelioma and adenocarcinoma of the two best markers for the cEA and b72.3. Also positive for adenocarcinoma of the specificity of 100%, sensitivity 88%; both positive and specificity of 99% of mesothelioma, a sensitivity of 97%. cEA, b72.3 and leu-M1 in combination can achieve 74% of cases diagnosed broken out. ordonez 6 analysis that cEA, leu-M1, b72.3 is the best marker, and ber-EP4 application with more than 90% could mesothelioma and adenocarcinoma diagnosis made out off. 7 riera application of heat such as sewing methods used antibodies antibody re-re, aware of most of the antibodies in their sensitivity to heat increased after antibody mending, and specificity did not decline. And awareness cEA, bg8 and ber-EP4 to distinguish between epithelial mesothelioma and adenocarcinoma of the best markers. Three combined, the order of application, can be even partially accurate area of mesothelioma and adenocarcinoma of solidarity. Mesothelial coherent antibody hBME-1, thrombom odulin and calretinin sensitivity and specificity of antibody lower than the above. However, the antibody combination and help mesothelioma diagnosis. 4.2 malignant epithelial mesothelioma and adenocarcinoma and usefulness of the identification of benign and malignant mesothelial hyperplasia of the skin cells to distinguish between the diagnosis was difficulty in the pathological diagnosis. 8 eMA and p53 in benign and malignant diagnosis of mesothelial cells to identify a specific value. 9 wolanski applications such as biopsy specimens of thymus film analysis, awareness eMA positive rate in malignant lesions in 73%, and 1 case of benign lesions in the non-positive. The cEA, eMA and b72.3 combination for distinguishing benign mesothelial hyperplasia and adenocarcinoma of the useful markers. b72.3 in breast cancer, lung cancer, ovarian cancer effusions were positive utility, and benign effusion in 1 case no positive 10. 4.3 neoplasm and neoplasm-like mesothelioma, localized fibrous tumor and usefulness of the tympanic membrane fibrosis, mesothelioma identify the expression of neoplasia lower members of the protractor-like protein, neoplasia, localized fibrous tumors and fibrosis did not express the effectiveness of the eardrum keratin any situation. With broad-spectrum keratin marker aE1 / aE3 and low protein cAM5.2 decent members of the protractor-like mesothelioma and limitations of neoplasm fibroma, desmoid-like mesothelioma and usefulness of the unity of the eardrum fibrosis area . 11 montag so aware of 30 cases of neoplasia analysis of sample type and mixed type of neoplasia mesothelioma plots are on the aE1 / aE3 effective, while 10 institutions of 39 types of tumors and tumor-like spindle cells were positive for the process only a small number of spindle cell tumors such as synovial neoplasia, epithelial neoplasia, neoplasm-like carcinoma, neoplasm sudden positive. Mesothelial coherent antibody (hBME-1, thrombo-modulin, calretinin) in the neoplasm-like mesothelioma in the positive samples in the neoplasm the diagnosis of mesothelioma identify worthless 10. 5 NOR associated proteins (agNOR) survey agNOR reflects the proliferation of nuclear activity. In recent years, that the ag-NOR analysis of the different characteristics (number, size, distribution) to distinguish benign and malignant lesions in the diagnosis of a specific value. 12 Wu Xia and other analysis of perceived usefulness of malignant mesothelioma and mesothelial hyperplasia of the important differences between the two as follows: malignant mesothelioma agNOR uniform value of the total particles 4.26 1.28, usefulness of the proliferation of mesothelial cells 1.28 0.38; malignant mesothelioma of the nuclear particles containing 1 or 2, uniform value of 4.42 1.20,2.38 0.38; usefulness of the separation of mesothelial cells proliferation was 1.28 0.31,1.7 0.48; malignant mesothelioma of the nuclear particles within the agNOR diameter 2.6 m, accounting for 84.33%, mesothelial hyperplasia utility only 0.48%. These three indicators can be used to identify malignant mesothelioma, mesothelial hyperplasia and effectiveness of an objective basis. However, even benign and malignant mesothelial cell count has agNOR overlap areas, such as the ag-NOR area 0.6677 m2 particles as the upper limit of benign mesothelial, the diagnosis of malignant mesothelioma, 100% specificity, sensitivity was 63.8%; and eMA combined, the sensitivity can be revolutionary to 95%, while very few false positives 9. Recent analysis by image analysis capacity so that the method is fast, accurate and objective strengths. Decent as benign and malignant mesothelial cells to identify a complementary diagnostic method for diagnosis. 6, cytological investigation dMM frequently with pleural effusion. Therefore, the pleural fluid cytology is still the most commonly used survey, the most important methods of investigation. Mesothelial cells of malignant pleural effusion often has papillary, nodular distribution, an example for those who were "mulberry-like", the key may be associated with fiber blood samples; also showed scattered single cells sp, or both mixed there. Multinucleated giant cells with malignant plasma cells and small stain of peripheral vacuoles as useful diagnostic features. Nuclear and nucleolar mild rules, but the nuclear / cytoplasm ratio was normal. And other types of cancer cell size and shape vary greatly, once the size of malignant cells is another decent degree of malignant cells several times the size, large nucleoli, nuclear / plasma ratio increased. But any of these features are nonspecific, pleural mesothelioma is to establish awareness in a variety of excellent comprehensive reon the. dMM pleural fluid cytology positive rate is low, renshaw comprehensive lesson plan reported in 7% to 77%, and the specific diagnosis of mesothelioma made of the sensitivity of 4% to 63%. Therefore, if the clinical and pleural fluid cytology trust investigation dMM positive, other methods should be investigated, such as chest cT, percutaneous pleural biopsy, thoracoscopy survey thoracotomy pleural biopsy. Xue Lifu, etc. 13 survey reported thoracoscopic diagnosis of pleural mesothelioma was 100%, can replace thoracotomy pleural biopsy. 7, pleural effusion cytogenetic cytogenetic survey horizontal control survey to identify the copy number of the cancer cells and (or) structure on the well, and aware of the existence of mesothelioma cells in the body abnormal consistency textile 14, as in most of loss of specific regions of the textile body, the most common area for the loss of textile body of textile No. 1,3,9 and 22, short arm of the long arm of the textile body. No. 9 in the textile and loss of body centromere most common, and its present rate of 73% 3%, just missing part of the gene for the mTS1 location. Speculated that gene loss and dMM mTS1 presentation on. 15 granados other cases of 10 patients trust dMM genetics study of the pleural effusion cells, aware of some cases in which there are one or several parts of the body region loss of the textile. And 6 patients with non-vertical Fan Zengsheng mesothelial textile bodies were not aware of fake anomalous. And proposed a variety of markers of textile body observed and (or) copy of the changes on the value of a decent revolution cytogenetic diagnostic accuracy. Other types of tumor cells, to accommodate non-small cell lung cancer, also showed dMM characteristic partial loss of the textile body. But dMM karyotype karyotype simply not cancer, lung cancer more than 10 copy of the abnormal cells and how each copy of the changes. The changes in malignant mesothelioma copy no more than 10 species, and little variation between cells. Therefore, cytogenetic investigations decent survey as dMM cytology diagnosis method was useful in identifying the effectiveness of mesothelial cells and malignant mesothelioma cell areas of great value. 8, pleural fluid hyaluronan secretion of a large number of default as dMM hyaluronic acid, neutral mucin secreting adenocarcinoma. Therefore, hyaluronic acid in pleural effusion and lung adenocarcinoma default help dMM distinguished. However, some benign effusions eardrum can also increase the concentration of hyaluronic acid. Default by the eardrum effusion electrophoresis of hyaluronic acid concentration above 50mg · l-1, 82% are caused by the mesothelioma. Default by high performance liquid chromatography of hyaluronic acid is 75mg · l-1, the specificity of 100% of mesothelioma 16.


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