Pleura, Malignant mesothelioma, biphasic type [LMP72954]

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Image Details
Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Malignant mesothelioma, biphasic type
Species: 
Human
Organ System: 
Lung
Gender: 
Female
Age: 
68 years
Diagnosis Code: 
ICD-10: C45.0 | ICD-O: 9050/3
Slide Contributor Information
Forse, C., Lu, F.

Keywords

thoracic, mesothelial, biphasic

Clinical History

Patient presents with bilateral pleural effusions and shortness of breath. She had a history of smoking and working in housing renovation projects.

Clinical Discussion

Malignant mesothelioma of the pleura is a malignant tumour arising from mesothelial cells. The most common etiological factors include asbestos exposure, erionite (unique fibres found in Turkey), radiation and inherited predisposition (ie. germline mutations in BAP1). Common genetic mutations include a homozygous deletion of CDKN2/INK4a and BAP1 loss. While the most common diffuse histological variant of malignant mesothelioma is epithelioid mesothelioma (90% of tumours), this slide shows the second most common which is the biphasic type (10-15% of tumours). Biphasic mesothelioma is a tumour with both epithelioid and sarcomatoid patterns, with at least 10% of each type identified. Note the cytological atypia and nuclear pleomorphism in this specimen.