Lesions Simulating Malignant Pleural Mesothelioma
One interesting study is called, “Absence of SV40 large T-antigen 
expression in human mesothelioma cell lines.” By Pilatte Y, Vivo C, 
Renier A, Kheuang L, Greffard A, Jaurand MC - Am J Respir Cell Mol Biol.
 2000 Dec;23 (6):788-93. - INSERM, Créteil, France. Here is an excerpt: 
“Abstract - Simian virus (SV) 40 and SV40-like DNA sequences have 
recently been detected in several types of human tumors, including 
malignant mesothelioma.
However, the presence of SV40 DNA sequences is 
not sufficient to account for its possible role in tumor development 
because the viral proteins must be expressed and ultimately impair the 
function of relevant cell proteins, such as p53 and pRb. In this study 
we investigated SV40 large T antigen (SV40 Tag) protein expression in 
mesothelioma cell lines, established in our laboratory, by Western 
blotting, immunoprecipitation, and immunocytochemistry using 
Tag-specific mouse monoclonal antibodies (mAbs) Ab-1 (or Pab 419).
By 
Western blotting of cell extracts, none of the mesothelioma cell lines 
expressed detectable amounts of SV40 Tag. However, we found that Ab-1 as
 well as Pab-101, another SV 40 Tag-specific mAb, may generate 
false-positive signals due to the fact that both antibody preparations 
are contaminated by a protein of similar size (90 kD) as SV40 Tag and 
react with the various secondary horseradish peroxidase- conjugated 
antimouse immunoglobulin Gs tested. The present study suggests that 
immunodetection of SV40 Tag protein may be puzzling because this 
contaminating Taglike protein may bind to particular cell structures, 
thereby generating false-positive signals.”
Another study is called, “Pseudomesotheliomatous angiosarcoma: a 
pleuropulmonary lesion simulating malignant pleural Mesothelioma” by G. 
Falconieri, R. Bussani1, M. Mirra, M. Zanella – Histopathology Volume 
30, Issue 5, pages 419–424, May 1997.
Here is an excerpt: “We report two
 cases of autopsy confirmed angiosarcoma in adult males, presenting as 
diffuse pleuropulmonary tumours and simulating malignant mesothelioma. 
Both the lesions grew along the serosal surfaces and were characterized 
by variably thick rinds of tissue encasing the lung.
The pulmonary 
parenchyma showed diffuse, dark red, subpleural consolidations and 
multiple cavitations. Histologically, the lesions were composed by 
atypical spindle and polygonal, epithelioid cells showing rudimentary 
vascular differentiation and exhibiting strong positivity for factor 
VIII, CD31, CD34 and vimentin.
We conclude that angiosarcoma may present
 with preponderant or exclusive involvement of pleura and peripheral 
lung and that it should be added to the list of tumours capable of 
simulating malignant mesothelioma.”
Another study is called, “D2-40: A Reliable Marker in the Diagnosis of 
Pleural Mesothelioma” by Annette M. Müllera, Folker E. Frankeb, 
Klaus-Michael Müllera - Institute of Pathology, BG Clinics 
‘Bergmannsheil’, Ruhr University Bochum, Bochum, and Justus Liebig 
University, Giessen, Germany - Pathobiology 2006;73:50-54.
Here is an 
excerpt: “Abstract - Objective: Malignant mesotheliomas of the pleura, 
peritoneum and pericardium can easily be confused with either metastatic
 adenocarcinomas or reactive pleural lesions. D2-40, a monoclonal 
antibody used as a marker for seminomatous germ cell tumours and 
lymphatic endothelial cells, was recently described in mesothelial cells
 and type I but not type II pneumocytes.
Method: The immunoreactivities 
of D2-40 in 76 lung carcinomas of different histological types 
(adenocarcinomas, squamous cell, small cell, and bronchioloalveolar 
carcinomas) were compared with those of 36 pleural epithelioid and 
sarcomatoid mesotheliomas and 5 specimens of chronic pleuritis.
Results:
 While all 18 analysed epithelioid mesotheliomas displayed a strong 
membranous immunostaining, 18 sarcomatoid mesotheliomas showed no, or a 
merely faint, cytoplasmic signal, comparable with fibroblasts in chronic
 pleuritis. Out of all analysed lung carcinomas, 49 showed no 
immunoreactivity for D2-40 (64%), while the other 27 (36%) showed a 
focal weak to moderate and only cytoplasmic signal.
Conclusions: We 
regard D2-40 as a valid marker in the differential diagnosis of 
epithelioid mesotheliomas versus pulmonary adenocarcinomas. However, 
this marker may not properly label sarcomatoid mesotheliomas or 
distinguish them from reactive pleural lesions.”
We all owe a debt of gratitude to these fine researchers. If you found 
any of these excerpts interesting, please read the studies in their 
entirety.

 
 
 
 
 
 
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