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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