Present Role of Cytology in Diagnosing Malignant Pleural Mesothelioma
Pp. 233-246 (14)
Anders Hjerpe and Katalin Dobra
The possibility to diagnose malignant pleural mesothelioma (MPM) based on
an effusion gives cytology a central role in handling of these patients. Audits have
shown that effusion cytology, supported by one or more ancillary techniques, can
diagnose a majority of all MPMs. When a definite diagnosis is obtained, this is
beneficial for both patient and clinic. The cytological sample is easily accessible with
less invasive means. However, the sensitivity for reaching this diagnosis based on
cytology is 60-75%, i.e., somewhat lower than for the histopathologic examination of a
biopsy, the exact level depending on the extent of ancillary analyses available. The
cytological diagnoisis require support from immunohistochemistry and/or electron
microscopy, and the sensitivity can be improved by testing soluble biomarkers
(hyaluronan and mesothelin).
Cytology, desmin, EMA, malignant pleural mesothelioma, pleural
Department of Laboratory Medicine, Division of Clinical Pathology, Karolinska Institutet, Huddinge, Sweden.